Provider First Line Business Practice Location Address:
1 PLAZA STREET
Provider Second Line Business Practice Location Address:
1D
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11217
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-783-3720
Provider Business Practice Location Address Fax Number:
718-783-3720
Provider Enumeration Date:
05/03/2007