Provider First Line Business Practice Location Address:
1049 38 STREET
Provider Second Line Business Practice Location Address:
HEALTH CARE GROUP PROVIDER
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11219
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-633-5328
Provider Business Practice Location Address Fax Number:
718-633-5331
Provider Enumeration Date:
11/21/2012