Provider First Line Business Practice Location Address:
1543-1545 INWOOD AVENUE, BRONX ADHCP
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10452-2001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-681-8700
Provider Business Practice Location Address Fax Number:
646-380-1322
Provider Enumeration Date:
03/02/2015