Provider First Line Business Practice Location Address:
ALEXANDER BAKIS
Provider Second Line Business Practice Location Address:
2662 OCEAN AVE #A6,
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11229
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-646-0590
Provider Business Practice Location Address Fax Number:
718-646-6664
Provider Enumeration Date:
12/01/2006