Provider First Line Business Practice Location Address:
HEALTH SERVICE AT COLUMBIA
Provider Second Line Business Practice Location Address:
519 WEST 114TH STREET
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10027
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-854-9842
Provider Business Practice Location Address Fax Number:
212-854-9851
Provider Enumeration Date:
02/12/2007