Provider First Line Business Practice Location Address:
HEALTH SCIENCES CENTER T16-020
Provider Second Line Business Practice Location Address:
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:
11790-0988
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-444-1106
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/01/2011