Provider First Line Business Practice Location Address:
STONY BROOK MEDICINE DEPARTMENT OF SURGERY
Provider Second Line Business Practice Location Address:
HEALTH SCIENCE TOWER, LEVEL 19, ROOM 030
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:
631-444-1791
Provider Business Practice Location Address Fax Number:
631-444-7689
Provider Enumeration Date:
04/22/2016