Provider First Line Business Practice Location Address:
228 LIVINGSTON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11201-5859
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-625-2137
Provider Business Practice Location Address Fax Number:
718-875-8080
Provider Enumeration Date:
09/10/2008