Provider First Line Business Practice Location Address:
380 E 18TH ST
Provider Second Line Business Practice Location Address:
APT LD
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11226-5776
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-287-4220
Provider Business Practice Location Address Fax Number:
718-287-0231
Provider Enumeration Date:
11/15/2005