Provider First Line Business Practice Location Address:
235 DONGAN HILLS AVE SUITE 2B
Provider Second Line Business Practice Location Address:
OCEAN BREEZE HEALTHCARE
Provider Business Practice Location Address City Name:
STATEN ISLAND
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10305-1918
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-219-5920
Provider Business Practice Location Address Fax Number:
800-219-5921
Provider Enumeration Date:
02/05/2010