Provider First Line Business Practice Location Address:
451 CLARKSON AVE
Provider Second Line Business Practice Location Address:
KINGS COUNTY HOSPITAL CENTER, ANESTH DEPT, B-2175
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11203-2057
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-245-4409
Provider Business Practice Location Address Fax Number:
718-778-3141
Provider Enumeration Date:
04/12/2006