Provider First Line Business Practice Location Address:
57-24 7TH AVENUE
Provider Second Line Business Practice Location Address:
1ST FLOOR FRONT
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11220
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-567-8288
Provider Business Practice Location Address Fax Number:
718-567-8287
Provider Enumeration Date:
03/17/2014