Provider First Line Business Practice Location Address:
450 CLINTON STREET
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:
11231
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-624-0222
Provider Business Practice Location Address Fax Number:
718-624-7130
Provider Enumeration Date:
10/31/2006