Provider First Line Business Practice Location Address:
977 48TH ST
Provider Second Line Business Practice Location Address:
DEPARTMENT OF PEDIATRICS
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11219-2919
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-283-8894
Provider Business Practice Location Address Fax Number:
718-635-7276
Provider Enumeration Date:
10/16/2006