Provider First Line Business Practice Location Address:
3223 CHURCH AVE
Provider Second Line Business Practice Location Address:
NEW YORK AVENUE MEDICAL
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11226-4213
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-693-4900
Provider Business Practice Location Address Fax Number:
718-287-8946
Provider Enumeration Date:
07/22/2014