Provider First Line Business Practice Location Address:
184 EAST 70 ST SUITE B1
Provider Second Line Business Practice Location Address:
EAST SIDE MEDICAL AND CARDIOVASCULAR ASS, PC
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10021
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-249-1760
Provider Business Practice Location Address Fax Number:
212-249-2054
Provider Enumeration Date:
09/21/2005