Provider First Line Business Practice Location Address:
137 DEVOE ST
Provider Second Line Business Practice Location Address:
2L
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11211-3720
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-218-9390
Provider Business Practice Location Address Fax Number:
212-305-3389
Provider Enumeration Date:
01/08/2008