Provider First Line Business Practice Location Address:
226 CLINTON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HEMPSTEAD
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11550-2614
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-560-1860
Provider Business Practice Location Address Fax Number:
516-292-0807
Provider Enumeration Date:
03/22/2010