Provider First Line Business Practice Location Address:
THIRD AVENUE BRONX
Provider Second Line Business Practice Location Address:
SBH HEALTH SYSTEM 4422
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10457
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-960-9000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/21/2021