Provider First Line Business Practice Location Address:
2212 PLUMB 1ST ST APT 6E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11229-5762
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
646-773-4022
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/14/2024