Provider First Line Business Practice Location Address:
9000 SHORE ROAD, EAST BUILDING, LOWER LOBBY
Provider Second Line Business Practice Location Address:
SHORE ROAD REHABILITATION
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11209-5449
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-921-2945
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/21/2007