Provider First Line Business Practice Location Address:
STONY BROOK UNIVERSITY HOSPITAL
Provider Second Line Business Practice Location Address:
DEPT OF FAMILY MEDICINE HSC 4
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:
631-444-3917
Provider Business Practice Location Address Fax Number:
631-444-7552
Provider Enumeration Date:
03/24/2008