Provider First Line Business Practice Location Address:
9525 QUEENS BLVD
Provider Second Line Business Practice Location Address:
2ND FL NEUROSURGERY DEPT
Provider Business Practice Location Address City Name:
REGO PARK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11374
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-459-7700
Provider Business Practice Location Address Fax Number:
718-286-1140
Provider Enumeration Date:
01/23/2007