Provider First Line Business Practice Location Address:
656 NO WELLWOOD AVE
Provider Second Line Business Practice Location Address:
LOUIS LASKY MEMORIAL MEDICAL AND DENTAL CENTER
Provider Business Practice Location Address City Name:
LINDENHURST
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11757-1695
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-225-1010
Provider Business Practice Location Address Fax Number:
631-225-1004
Provider Enumeration Date:
03/29/2007