Provider First Line Business Practice Location Address:
2 ALLEN STREET
Provider Second Line Business Practice Location Address:
CELLAR
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10002-5302
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-566-6288
Provider Business Practice Location Address Fax Number:
212-732-2412
Provider Enumeration Date:
12/04/2006