| Street | 1490 5th Ave | ||
| City/Town | Bay Shore | ||
| State/Province/Region | New York | ||
| Zip/Postal Code | 11706 | ||
| Phone Number | (631) 665-0213 | ||
| Country | United States |
| Full Name | Mr. Sam Flatley DVM | ||
| Gender | male | ||
| Birthday | 1985-09-18 | ||
| Social Security Number | 236-55-4441 |
| Credit card brand | Discover | ||
| Credit card number | 6011027563952545 | ||
| Expire | 2029/7 | ||
| CVV | 884 |