Provider First Line Business Practice Location Address:
DEPARTMENT OF CLINICAL NUTRITION RM 747A LEVEL 1
Provider Second Line Business Practice Location Address:
STONY BROOK UNIVERSITY MEDICAL CENTER
Provider Business Practice Location Address City Name:
STONY BROOK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11794-7008
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-444-1442
Provider Business Practice Location Address Fax Number:
631-632-2690
Provider Enumeration Date:
03/30/2010