Provider First Line Business Practice Location Address:
432 WESTERN AVENUE
Provider Second Line Business Practice Location Address:
PAULINE K. WINKLER CENTER AT THE COLLEGE OF SAINT ROSE
Provider Business Practice Location Address City Name:
ALBANY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12203-1409
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-485-3944
Provider Business Practice Location Address Fax Number:
518-337-2313
Provider Enumeration Date:
07/12/2010