Provider First Line Business Practice Location Address:
255 S 2ND 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:
11211-8770
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-388-0745
Provider Business Practice Location Address Fax Number:
718-486-8488
Provider Enumeration Date:
11/12/2008