Provider First Line Business Practice Location Address:
550 1ST AVENUE
Provider Second Line Business Practice Location Address:
NYU LANGONE MEDICAL CENTER
Provider Business Practice Location Address City Name:
NY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10016-6402
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-263-5506
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/23/2012