Provider First Line Business Practice Location Address:
751 SEAMANS NECK ROAD
Provider Second Line Business Practice Location Address:
EAST BROADWAY SCHOOL
Provider Business Practice Location Address City Name:
SEAFORD
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11783
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-783-5180
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/24/2013