Provider First Line Business Practice Location Address:
89 36 VAN WYCK EXPRESSWAY
Provider Second Line Business Practice Location Address:
MAIN LOBBY JAMAICA HOSP
Provider Business Practice Location Address City Name:
JAMAICA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11418
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-206-8515
Provider Business Practice Location Address Fax Number:
718-206-8530
Provider Enumeration Date:
02/07/2007