Provider First Line Business Practice Location Address:
2 PRO HEALTH PLZ
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW HYDE PARK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11042-1111
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-506-6885
Provider Business Practice Location Address Fax Number:
516-608-6824
Provider Enumeration Date:
11/07/2006