Provider First Line Business Practice Location Address:
60 EIGHTH AVENUE
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:
11217
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-636-0019
Provider Business Practice Location Address Fax Number:
718-636-3951
Provider Enumeration Date:
10/26/2006