Provider First Line Business Practice Location Address:
1500 WATERS PL
Provider Second Line Business Practice Location Address:
GINSBURG OUT-PATIENT CLINIC,
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10461-2723
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-862-4568
Provider Business Practice Location Address Fax Number:
718-861-4862
Provider Enumeration Date:
08/25/2010