Provider First Line Business Practice Location Address:
201 BARBEY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11207-2703
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
917-923-5341
Provider Business Practice Location Address Fax Number:
347-233-4021
Provider Enumeration Date:
01/22/2014