Provider First Line Business Practice Location Address:
34 PLAZA ST E
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:
11238-5038
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-638-2700
Provider Business Practice Location Address Fax Number:
718-638-3271
Provider Enumeration Date:
07/31/2006