Provider First Line Business Practice Location Address:
8268 164TH STREET
Provider Second Line Business Practice Location Address:
FOOD AND NUTRITION DEPARTMENT
Provider Business Practice Location Address City Name:
JAMAICA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11432-1143
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-883-3841
Provider Business Practice Location Address Fax Number:
718-883-3841
Provider Enumeration Date:
01/02/2018