Provider First Line Business Practice Location Address:
DEPARTMENT OF MEDICINE MEDICAL SERVICE GROUP
Provider Second Line Business Practice Location Address:
1873 WESTERN AVE, SUITE 100
Provider Business Practice Location Address City Name:
ALBANY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12203
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-250-4359
Provider Business Practice Location Address Fax Number:
518-250-4678
Provider Enumeration Date:
06/27/2006