Provider First Line Business Practice Location Address:
2433 KNAPP ST STE 102
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:
11235-1005
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-880-8980
Provider Business Practice Location Address Fax Number:
718-880-8981
Provider Enumeration Date:
07/01/2020