Provider First Line Business Practice Location Address:
1355 84 STREET
Provider Second Line Business Practice Location Address:
UPK CENTER
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11209
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-621-8510
Provider Business Practice Location Address Fax Number:
718-621-8515
Provider Enumeration Date:
12/13/2016