Provider First Line Business Practice Location Address:
ROOM 222 CHC, DEPARTMENT OF SURGICAL SERVICES, THE BROO
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROOKDALE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11212
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-240-6386
Provider Business Practice Location Address Fax Number:
718-240-6738
Provider Enumeration Date:
04/13/2020