Provider First Line Business Practice Location Address:
234 EAST 149TH STREET, 2C2 ROOM 445A
Provider Second Line Business Practice Location Address:
DEPARTMENT OF EMERGENCY MEDICINE,
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10451
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-579-6011
Provider Business Practice Location Address Fax Number:
718-579-4822
Provider Enumeration Date:
04/28/2017