Provider First Line Business Practice Location Address:
3041 AVENUE U, 1ST FLOOR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROOOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11229
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-615-0049
Provider Business Practice Location Address Fax Number:
718-646-5315
Provider Enumeration Date:
07/20/2010