Provider First Line Business Practice Location Address:
4802 10TH AVE
Provider Second Line Business Practice Location Address:
MAIMONIDES MEDICAL CENTER
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11219-2844
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-283-7949
Provider Business Practice Location Address Fax Number:
718-283-8268
Provider Enumeration Date:
09/06/2005