Provider First Line Business Practice Location Address:
148 7TH AVE
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:
11215-2271
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-399-1825
Provider Business Practice Location Address Fax Number:
718-638-5589
Provider Enumeration Date:
07/03/2007