Provider First Line Business Practice Location Address:
234 EAST 149TH STREET
Provider Second Line Business Practice Location Address:
MEDICINE DEPARTMENT 8TH FLOOR
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10451
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-579-5182
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/23/2013