Provider First Line Business Practice Location Address:
3131 KINGS HWY
Provider Second Line Business Practice Location Address:
SUITE B8
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11234-2644
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-377-2327
Provider Business Practice Location Address Fax Number:
718-377-3948
Provider Enumeration Date:
02/08/2008