Provider First Line Business Practice Location Address:
295 FLATBUSH AVENUE EXTENSION - STD (2ND FLOOR)
Provider Second Line Business Practice Location Address:
DOHMH
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-643-4133
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/11/2009