Provider First Line Business Practice Location Address:
CARE OF 730 ROCKAWAY AVE
Provider Second Line Business Practice Location Address:
APT 7K
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11212
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
347-365-5554
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/02/2024