Provider First Line Business Practice Location Address:
26 NEWKIRK PLZ
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11226-6525
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-434-7545
Provider Business Practice Location Address Fax Number:
718-434-7564
Provider Enumeration Date:
08/04/2005