Provider First Line Business Practice Location Address:
506 SIXTH STREET
Provider Second Line Business Practice Location Address:
NEW YORK METHODIST HOSPITAL
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11215-9008
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-768-4313
Provider Business Practice Location Address Fax Number:
718-965-3672
Provider Enumeration Date:
08/16/2010