Provider First Line Business Practice Location Address:
1ST AVE AT 16TH STREET
Provider Second Line Business Practice Location Address:
BETH ISRAEL MEDICAL CENTRE, 4 DASIAN
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-420-4170
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/14/2014