Provider First Line Business Practice Location Address:
HSC T18 060
Provider Second Line Business Practice Location Address:
STONY BROOK UNIVERSITY MEDICAL CENTER
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:
631-444-1047
Provider Business Practice Location Address Fax Number:
631-444-6348
Provider Enumeration Date:
06/26/2008