Provider First Line Business Practice Location Address:
270 FLABUSH AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11217
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-622-5144
Provider Business Practice Location Address Fax Number:
718-622-4795
Provider Enumeration Date:
02/28/2007