Provider First Line Business Practice Location Address:
32-02 JUNCTION BLVD
Provider Second Line Business Practice Location Address:
IS 227 LOUIS ARMSTRONG MIDDLE SCHOOL
Provider Business Practice Location Address City Name:
E ELMHURST
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11369
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-335-7500
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/23/2008