Provider First Line Business Practice Location Address:
100 05 ROOSEVELT AVE
Provider Second Line Business Practice Location Address:
SALVADOR PEREZ MEDICAL P.C.
Provider Business Practice Location Address City Name:
CORONA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11368
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
646-761-4774
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/01/2012