Provider First Line Business Practice Location Address:
1235 LINDEN BLVD
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:
11212
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-240-8388
Provider Business Practice Location Address Fax Number:
917-947-8507
Provider Enumeration Date:
12/26/2013