Provider First Line Business Practice Location Address:
1619 THIRD AVENUE
Provider Second Line Business Practice Location Address:
KINGS THIRD AVENUE PHARMACY
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10128-4661
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-534-6000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/21/2014