Provider First Line Business Practice Location Address:
9302 KINGS HWY
Provider Second Line Business Practice Location Address:
APT E3
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11212-1752
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-872-6876
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/11/2008