Provider First Line Business Practice Location Address:
934 MYRTLE AVE
Provider Second Line Business Practice Location Address:
C/O QASIM PHARMACY INC
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11206-6526
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-919-5075
Provider Business Practice Location Address Fax Number:
718-919-3492
Provider Enumeration Date:
12/06/2008