Provider First Line Business Practice Location Address:
125 WORTH ST. ROOM 207 CN-73
Provider Second Line Business Practice Location Address:
BSTDC-NYC DEPT OF HEALTH AND MENTAL HYGIENE
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10013-4090
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-788-6614
Provider Business Practice Location Address Fax Number:
212-788-4431
Provider Enumeration Date:
09/25/2009