Provider First Line Business Practice Location Address:
1372 METROPOLITAN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10462-7445
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-828-8344
Provider Business Practice Location Address Fax Number:
718-281-1913
Provider Enumeration Date:
08/19/2006