Provider First Line Business Practice Location Address:
107 WEST 4TH STREET
Provider Second Line Business Practice Location Address:
MOUNT VERNON NEIGHBORHOOD HEALTH CENTER
Provider Business Practice Location Address City Name:
MT VERNON
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10550
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-699-7200
Provider Business Practice Location Address Fax Number:
914-699-0837
Provider Enumeration Date:
12/06/2006