Provider First Line Business Practice Location Address:
825 EAST GATE BLVD.
Provider Second Line Business Practice Location Address:
SUITE 101B MARIAN CARE INC
Provider Business Practice Location Address City Name:
GARDEN CITY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11530
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-471-8600
Provider Business Practice Location Address Fax Number:
516-408-3111
Provider Enumeration Date:
01/06/2009