Provider First Line Business Practice Location Address:
P.S. 140 166-01 116TH AVE.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JAMAICA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11434
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-657-4760
Provider Business Practice Location Address Fax Number:
718-526-1051
Provider Enumeration Date:
03/28/2012