Provider First Line Business Practice Location Address: 
BROOKDALE MEDICAL CENTER 1 BROOKDALE PLAZA 102 SNAPPER
    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: 
11212-3198
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
718-240-6278
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
02/14/2007