Provider First Line Business Practice Location Address:
514 49TH ST
Provider Second Line Business Practice Location Address:
LUTHERAN FHC SUNSET TERRACE
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11220-2010
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-854-1851
Provider Business Practice Location Address Fax Number:
718-435-8510
Provider Enumeration Date:
12/21/2006