Provider First Line Business Practice Location Address:
77 CLINTONAVE
Provider Second Line Business Practice Location Address:
BENJAMIN BANNEKER SCHOOL CLINIC
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11205
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-834-2981
Provider Business Practice Location Address Fax Number:
719-834-4782
Provider Enumeration Date:
02/17/2006