Provider First Line Business Practice Location Address:
1 GUSTAVE L LEVY PLACE
Provider Second Line Business Practice Location Address:
BOX 1430- MOUNT SINAI HOSPITAL
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10029-6574
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-987-3063
Provider Business Practice Location Address Fax Number:
212-987-6322
Provider Enumeration Date:
12/15/2008