Provider First Line Business Practice Location Address:
924 N BROADWAY # 2
Provider Second Line Business Practice Location Address:
ISLAND NEUROLOGICAL THERAPY, PC
Provider Business Practice Location Address City Name:
MASSAPEQUA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11758-2303
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-520-5507
Provider Business Practice Location Address Fax Number:
516-520-5493
Provider Enumeration Date:
02/15/2006