Provider First Line Business Practice Location Address:
264 1ST ST
Provider Second Line Business Practice Location Address:
# 4G
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11215-1902
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-499-6299
Provider Business Practice Location Address Fax Number:
718-499-6399
Provider Enumeration Date:
08/18/2009