Provider First Line Business Practice Location Address:
2215 NEWKIRK AVE APT B12
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:
11226-7523
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-255-7420
Provider Business Practice Location Address Fax Number:
347-402-2588
Provider Enumeration Date:
11/18/2024