Provider First Line Business Practice Location Address:
135TH STREET AT CONVENT AVE
Provider Second Line Business Practice Location Address:
A. PHILIP RANDOLPH HS-HEALTH CLINIC
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10031
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-862-2203
Provider Business Practice Location Address Fax Number:
212-862-2774
Provider Enumeration Date:
01/31/2007