Provider First Line Business Practice Location Address:
303 9TH AVE
Provider Second Line Business Practice Location Address:
CHELSEA HEALTH CLINIC ROOM 219
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10001-5701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-239-1720
Provider Business Practice Location Address Fax Number:
212-571-0558
Provider Enumeration Date:
02/28/2014