Provider First Line Business Practice Location Address:
701-01 BROADWAY, A1-16
Provider Second Line Business Practice Location Address:
MOUNT SINAI SERVICES ELMHURST HOSPITAL CENTER
Provider Business Practice Location Address City Name:
ELMHURST
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11373
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-334-4000
Provider Business Practice Location Address Fax Number:
718-334-5845
Provider Enumeration Date:
03/24/2017