Provider First Line Business Practice Location Address:
557 PENNSYLVANIA AVE, ROOM 155
Provider Second Line Business Practice Location Address:
ICL SCHOOL BASED PROGRAM AT PS13
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11207
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-922-7098
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/03/2016