Provider First Line Business Practice Location Address:
2640 PITKIN AVE
Provider Second Line Business Practice Location Address:
OASAS
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11208-2629
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-827-8700
Provider Business Practice Location Address Fax Number:
718-827-0550
Provider Enumeration Date:
10/15/2015