Provider First Line Business Practice Location Address:
330 E 17TH ST
Provider Second Line Business Practice Location Address:
BETH ISRAEL MEDICAL CENTER, DEPT OF EMERGENCY MEDICINE
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10003-3805
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-420-2847
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/29/2008