Provider First Line Business Practice Location Address:
STONY BROOK UNIV.HOSPITAL-RM.15-082
Provider Second Line Business Practice Location Address:
NICHOLLS RD
Provider Business Practice Location Address City Name:
STONY BROOK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11794-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-444-1242
Provider Business Practice Location Address Fax Number:
631-444-1235
Provider Enumeration Date:
11/08/2005