Provider First Line Business Practice Location Address:
22 CHAPEL ST
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:
11201-1903
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-495-1801
Provider Business Practice Location Address Fax Number:
718-566-8563
Provider Enumeration Date:
07/11/2007