Provider First Line Business Practice Location Address: 
BROOKLYN VAMC
    Provider Second Line Business Practice Location Address: 
800 POLY PLACE, MS 11 M
    Provider Business Practice Location Address City Name: 
BROOKLYN
    Provider Business Practice Location Address State Name: 
NY
    Provider Business Practice Location Address Postal Code: 
11209
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
718-836-6600
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
06/16/2006