Provider First Line Business Practice Location Address:
151 MAUJER ST
Provider Second Line Business Practice Location Address:
WILLIAMSBURG CHC
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11206-1220
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-387-2211
Provider Business Practice Location Address Fax Number:
718-387-6655
Provider Enumeration Date:
07/03/2006