Provider First Line Business Practice Location Address:
3411 WAYNE AVE
Provider Second Line Business Practice Location Address:
6TH FLOOR, DEPT OF EMERGENCY MEDICINE
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10467-2509
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-920-5731
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/05/2011