Provider First Line Business Practice Location Address:
2515 AVENUE L
Provider Second Line Business Practice Location Address:
THE GIL HODGES SCHOOL
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11210-4546
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-338-9011
Provider Business Practice Location Address Fax Number:
718-338-9074
Provider Enumeration Date:
03/13/2012