Provider First Line Business Practice Location Address:
241 S. OCEAN AVENUE.
Provider Second Line Business Practice Location Address:
PATCHOGUE-MEDFORD SCHOOL DISTRICT
Provider Business Practice Location Address City Name:
PATCHOGUE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11772
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-687-8706
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/11/2012