Provider First Line Business Practice Location Address: 
2270 KIMBALL STREET
    Provider Second Line Business Practice Location Address: 
TRAUBE MARUSH PLAWES MD PC
    Provider Business Practice Location Address City Name: 
BROOKLYN
    Provider Business Practice Location Address State Name: 
NY
    Provider Business Practice Location Address Postal Code: 
11234
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
718-692-2700
    Provider Business Practice Location Address Fax Number: 
718-677-6329
    Provider Enumeration Date: 
09/16/2006