Provider First Line Business Practice Location Address:
55 WATER ST
Provider Second Line Business Practice Location Address:
HIP HEALTH PLAN OF NEW YORK, 12TH FLOOR
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10041-0004
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
646-447-7977
Provider Business Practice Location Address Fax Number:
646-447-3234
Provider Enumeration Date:
07/30/2007