Provider First Line Business Practice Location Address:
115 1/2 REMSEN ST
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:
11201-4212
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-852-4949
Provider Business Practice Location Address Fax Number:
718-624-5972
Provider Enumeration Date:
07/18/2006