Provider First Line Business Practice Location Address: 
16 GUION PL
    Provider Second Line Business Practice Location Address: 
SOUND SHORE MEDICAL CENTER OF WESTCHESTER
    Provider Business Practice Location Address City Name: 
NEW ROCHELLE
    Provider Business Practice Location Address State Name: 
NY
    Provider Business Practice Location Address Postal Code: 
10801-5503
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
914-637-1186
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
08/14/2006