Provider First Line Business Practice Location Address:
STONY BROOK UNIVERSITY MEDICAL CTR
Provider Second Line Business Practice Location Address:
HSC T-15 RM080
Provider Business Practice Location Address City Name:
STONY BROOK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11794-8153
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-444-4793
Provider Business Practice Location Address Fax Number:
631-444-4695
Provider Enumeration Date:
03/28/2007