Provider First Line Business Practice Location Address:
4422 3RD AVE BLDG 3
Provider Second Line Business Practice Location Address:
DEPT OF INTERNAL MEDICINE
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10457-2545
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-725-7619
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/23/2016