Provider First Line Business Practice Location Address:
4 SUMMIT LANE
Provider Second Line Business Practice Location Address:
SUMMIT LANE SCHOOL
Provider Business Practice Location Address City Name:
LEVITTOWN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11756
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-520-8385
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/26/2011