Provider First Line Business Practice Location Address:
552 SAINT MARKS AVE
Provider Second Line Business Practice Location Address:
STREET LEVEL
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11238
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-230-3321
Provider Business Practice Location Address Fax Number:
718-230-3383
Provider Enumeration Date:
11/30/2005