Provider First Line Business Practice Location Address:
SUNY AT STONY BROOK DEPT OF GASTRO HSC T 17
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STONY BROOK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11794-8160
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-444-2119
Provider Business Practice Location Address Fax Number:
631-444-8886
Provider Enumeration Date:
05/14/2012