Provider First Line Business Practice Location Address:
1400 PELHAM PARKWAY SOUTH ROOM 1E4
Provider Second Line Business Practice Location Address:
JACOBI MEDICAL CENTER
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10471
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-918-4401
Provider Business Practice Location Address Fax Number:
718-918-7772
Provider Enumeration Date:
02/22/2013