Provider First Line Business Practice Location Address:
259 FIRST STREET
Provider Second Line Business Practice Location Address:
WINTHROP UNIVERSITY HOSPITAL GP4
Provider Business Practice Location Address City Name:
MINEOLA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11501
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-663-2384
Provider Business Practice Location Address Fax Number:
516-663-8288
Provider Enumeration Date:
05/01/2007