Provider First Line Business Practice Location Address:
205 ROCKAWAY PKWY
Provider Second Line Business Practice Location Address:
MEDICAL PRACTICE
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11212-3444
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-688-7000
Provider Business Practice Location Address Fax Number:
718-688-7185
Provider Enumeration Date:
02/27/2007