Provider First Line Business Practice Location Address:
2126 KNAPP 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:
11229-5609
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-332-5474
Provider Business Practice Location Address Fax Number:
718-332-7326
Provider Enumeration Date:
01/20/2025