Provider First Line Business Practice Location Address:
STONY BROOK LONG ISLAND CHILDRENS HOSPITAL
Provider Second Line Business Practice Location Address:
HSC 11 ROOM 060
Provider Business Practice Location Address City Name:
STONY BROOK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11794-8552
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-444-2706
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/13/2006