Provider First Line Business Practice Location Address:
217 8TH AVE
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11215
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-679-3659
Provider Business Practice Location Address Fax Number:
347-229-0350
Provider Enumeration Date:
05/14/2008