Provider First Line Business Practice Location Address:
BLDG. #19 , WEST RD.
Provider Second Line Business Practice Location Address:
MITCHEL COMPLEX FAMILY HEALTH CENTER
Provider Business Practice Location Address City Name:
GARDEN CITY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11530
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-222-0228
Provider Business Practice Location Address Fax Number:
516-745-1519
Provider Enumeration Date:
07/19/2006