Provider First Line Business Practice Location Address:
219 36TH ST
Provider Second Line Business Practice Location Address:
NO 25/GROUND FLOOR
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11232-2547
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
646-783-2992
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/03/2008