Provider First Line Business Practice Location Address:
ONE BROOKDALE PLAZA
Provider Second Line Business Practice Location Address:
ROOM 323 KATZ
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11212
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-240-6385
Provider Business Practice Location Address Fax Number:
718-240-6385
Provider Enumeration Date:
11/03/2006