Provider First Line Business Practice Location Address:
53 EIGHTH AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11217-3912
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-622-3535
Provider Business Practice Location Address Fax Number:
718-228-7678
Provider Enumeration Date:
11/08/2006