Provider First Line Business Practice Location Address:
55 SOUTH BROADWAY
Provider Second Line Business Practice Location Address:
HUDSON RIVER HEALTHCARE, INC. - HEALTH HOME
Provider Business Practice Location Address City Name:
TARRYTOWN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10591-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-734-8513
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/05/2018