Provider First Line Business Practice Location Address:
43 SCHOFIELD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10464-1531
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-885-1167
Provider Business Practice Location Address Fax Number:
718-885-1167
Provider Enumeration Date:
11/19/2008