Provider First Line Business Practice Location Address:
451 CLARKSON AVENUE
Provider Second Line Business Practice Location Address:
BLDG E, 5TH FLR, SUITE E KINGS COUNTY HOSPITAL CENTER
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11203-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-245-3280
Provider Business Practice Location Address Fax Number:
718-245-5508
Provider Enumeration Date:
10/01/2008