Provider First Line Business Practice Location Address:
DEPT OF MEDICINE
Provider Second Line Business Practice Location Address:
HSC T16-020 STONY BROOK UNIVERSITY
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:
641-444-8478
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/03/2007