Provider First Line Business Practice Location Address:
285 SCHERMERHORN STREET
Provider Second Line Business Practice Location Address:
MEDICAID SERVICE COORDINATOR 6TH FLOOR
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11217-1024
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-310-5796
Provider Business Practice Location Address Fax Number:
718-310-5879
Provider Enumeration Date:
12/06/2006