Provider First Line Business Practice Location Address:
CHILD AND ADOLESCENT PSYCHIATRY OUTPATIENT DEPARTMENT
Provider Second Line Business Practice Location Address:
169 PUTNAM HALL
Provider Business Practice Location Address City Name:
STONY BROOK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11794
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-632-8850
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/22/2007