Provider First Line Business Practice Location Address:
HSC T12-080
Provider Second Line Business Practice Location Address:
SUNY STONY BROOK/NEUROSURGERY
Provider Business Practice Location Address City Name:
STONY BROOK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11794-8122
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-444-7925
Provider Business Practice Location Address Fax Number:
631-444-1535
Provider Enumeration Date:
06/30/2008