Provider First Line Business Practice Location Address:
MOSHOLU PARK RADIOLOGY PC
Provider Second Line Business Practice Location Address:
3130 GRAND CONCOURSE STE 1P
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10458
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-933-6969
Provider Business Practice Location Address Fax Number:
718-933-6970
Provider Enumeration Date:
08/08/2006