Provider First Line Business Practice Location Address:
DEPT. OF PREVMENTIVE MEDICINE, HSC L-3, RM 086
Provider Second Line Business Practice Location Address:
STONY BROOK UNIVERSITY SCHOOL OF MEDICINE
Provider Business Practice Location Address City Name:
STONY BROOK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11794-8036
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-444-8267
Provider Business Practice Location Address Fax Number:
631-444-7525
Provider Enumeration Date:
10/18/2010