Provider First Line Business Practice Location Address:
622 KINGS HWY
Provider Second Line Business Practice Location Address:
2ND FLOOR
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11223-2253
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-627-7050
Provider Business Practice Location Address Fax Number:
718-627-4800
Provider Enumeration Date:
08/06/2007