Provider First Line Business Practice Location Address:
149 CONGRESS 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:
11201-6103
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-797-5339
Provider Business Practice Location Address Fax Number:
718-522-2211
Provider Enumeration Date:
01/05/2007