Provider First Line Business Practice Location Address:
27-19 33 STREET
Provider Second Line Business Practice Location Address:
BRIDGE PLAZA/ARBOR WE CARE
Provider Business Practice Location Address City Name:
LONG ISLAND CITY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-786-3921
Provider Business Practice Location Address Fax Number:
718-206-0051
Provider Enumeration Date:
09/11/2008