Provider First Line Business Practice Location Address:
546 EASTERN PKWY
Provider Second Line Business Practice Location Address:
GASTRO UNIT
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11225-1604
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-604-6831
Provider Business Practice Location Address Fax Number:
718-604-6822
Provider Enumeration Date:
06/04/2006