Provider First Line Business Practice Location Address:
535 2ND AVE
Provider Second Line Business Practice Location Address:
KIPS BAY ENDOSCOPY CENTER LLC
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10016-8275
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-889-5477
Provider Business Practice Location Address Fax Number:
212-889-0517
Provider Enumeration Date:
08/11/2006