Provider First Line Business Practice Location Address:
445 LENOX RD
Provider Second Line Business Practice Location Address:
DEPT OF PEDIATRICS, BOX 49
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11203-2098
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-270-1647
Provider Business Practice Location Address Fax Number:
718-270-1985
Provider Enumeration Date:
10/03/2006