Provider First Line Business Practice Location Address:
333 EARLE OVINGTON BLVD STE 106
Provider Second Line Business Practice Location Address:
HSS LONG ISLAND OUTPATIENT CENTER
Provider Business Practice Location Address City Name:
UNIONDALE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11553-3645
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-774-2668
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/11/2017