Provider First Line Business Practice Location Address:
50 SHORE BLVD
Provider Second Line Business Practice Location Address:
GROUND FLOOR
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11235-4057
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-769-9777
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/09/2008