Provider First Line Business Practice Location Address:
79-01 BROADWAY
Provider Second Line Business Practice Location Address:
DEPARTMENT OF PSYCHIATRY, ELMHURST HOSPITAL CENTER
Provider Business Practice Location Address City Name:
ELMHURST NEW YORK CITY
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:
718-334-3268
Provider Business Practice Location Address Fax Number:
718-334-3441
Provider Enumeration Date:
06/01/2021