Provider First Line Business Practice Location Address:
142 JORALEMON STREET - SUITE 8F.
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:
11201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-722-7577
Provider Business Practice Location Address Fax Number:
718-722-9955
Provider Enumeration Date:
12/22/2005