Provider First Line Business Practice Location Address:
195 MONTAGUE ST
Provider Second Line Business Practice Location Address:
2ND FLOOR MENTAL HEALTH
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11201-3631
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-250-0019
Provider Business Practice Location Address Fax Number:
718-488-9735
Provider Enumeration Date:
03/29/2006