Provider First Line Business Practice Location Address:
590 SHEFFIELD AVENUE
Provider Second Line Business Practice Location Address:
ROOM 300 - MEDICAL ROOM
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11207
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-346-8780
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/06/2012