Provider First Line Business Practice Location Address:
PLAZA 230 HILTON AVENUE
Provider Second Line Business Practice Location Address:
STE #10
Provider Business Practice Location Address City Name:
HEMPSTEAD
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11550
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-505-9500
Provider Business Practice Location Address Fax Number:
516-505-7448
Provider Enumeration Date:
11/10/2005