Provider First Line Business Practice Location Address:
1265 FRANKLIN AVE
Provider Second Line Business Practice Location Address:
MARTIN LUTHER KING HEALTH CENTER
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10456-3501
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-503-7700
Provider Business Practice Location Address Fax Number:
718-503-7755
Provider Enumeration Date:
11/15/2006