Provider First Line Business Practice Location Address:
267 CARLETON AVE
Provider Second Line Business Practice Location Address:
FAMILY HEALTH CARE CENTER, NY INSTITUTE OF TECHNOLOGY
Provider Business Practice Location Address City Name:
CENTRAL ISLIP
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11722-4543
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-348-3254
Provider Business Practice Location Address Fax Number:
631-348-3031
Provider Enumeration Date:
04/06/2006