Provider First Line Business Practice Location Address:
1404 BROOKLYN AVE
Provider Second Line Business Practice Location Address:
COMMUNITY CENTER
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11210-1805
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-282-2732
Provider Business Practice Location Address Fax Number:
718-282-7231
Provider Enumeration Date:
06/26/2020