Provider First Line Business Practice Location Address:
UNIVERSITY MEDICAL CENTER STONY BRK
Provider Second Line Business Practice Location Address:
DEPT. OF PEDIATRICS, HSC T11-040
Provider Business Practice Location Address City Name:
STONY BROOK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11794-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-444-2725
Provider Business Practice Location Address Fax Number:
631-444-2894
Provider Enumeration Date:
06/09/2008