Provider First Line Business Practice Location Address:
2025 KINGS HWY SECOND FLOOR
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:
11229-1173
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-645-2231
Provider Business Practice Location Address Fax Number:
718-663-2933
Provider Enumeration Date:
08/11/2005