Provider First Line Business Practice Location Address:
530 FIRST AVENUE, HCC 13
Provider Second Line Business Practice Location Address:
NYU LANGONE MEDICAL CENTER
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10016-1753
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
347-346-2560
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/10/2010