Provider First Line Business Practice Location Address:
3131 KINGS HIGHWAY
Provider Second Line Business Practice Location Address:
B9
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11234
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-338-0333
Provider Business Practice Location Address Fax Number:
718-252-0499
Provider Enumeration Date:
10/02/2006