Provider First Line Business Practice Location Address:
550 FIRST AVE
Provider Second Line Business Practice Location Address:
NYU LANGONE MEDICAL CENTER
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10016
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
347-753-6884
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/28/2017