Provider First Line Business Practice Location Address:
1PENN PLAZA, SUITE 725
Provider Second Line Business Practice Location Address:
OPTUM
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10119-3140
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
646-398-2325
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/03/2007