Provider First Line Business Practice Location Address:
80 WARREN ST
Provider Second Line Business Practice Location Address:
GROUND FLOOR MEDICAL OFFICE
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10007-1013
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-227-6967
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/26/2006