Provider First Line Business Practice Location Address:
4487 THIRD AVENUE
Provider Second Line Business Practice Location Address:
ST BARNABAS HOSPITAL
Provider Business Practice Location Address City Name:
BRONX
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:
718-960-6173
Provider Business Practice Location Address Fax Number:
718-960-9397
Provider Enumeration Date:
05/26/2011