Provider First Line Business Practice Location Address:
451 CLARKSON AVENUE
Provider Second Line Business Practice Location Address:
N BLDG RM 311 KINGS COUNTY HOSPITAL
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11203
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-245-2739
Provider Business Practice Location Address Fax Number:
718-270-1438
Provider Enumeration Date:
01/13/2006