Provider First Line Business Practice Location Address:
225 DRIGGS AVE
Provider Second Line Business Practice Location Address:
MEDICAL PLAZA
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11222
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-383-4555
Provider Business Practice Location Address Fax Number:
718-383-3290
Provider Enumeration Date:
06/02/2006