Provider First Line Business Practice Location Address:
FIRST AVENUE AT 27TH STREET
Provider Second Line Business Practice Location Address:
SUITE 10 SOUTH 1, BELLEVUE HOSPITAL
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10016
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-562-2227
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/06/2007