Provider First Line Business Practice Location Address:
1610 42ND ST
Provider Second Line Business Practice Location Address:
BROOKLYN, NY, USA
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11204-1026
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-435-8420
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/20/2010