Provider First Line Business Practice Location Address:
STONYBROOK UNIVESITY MEDICAL CTR
Provider Second Line Business Practice Location Address:
HSC T 17-040
Provider Business Practice Location Address City Name:
STONY BROOK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11794-8172
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-444-3869
Provider Business Practice Location Address Fax Number:
631-444-7502
Provider Enumeration Date:
06/18/2008