Provider First Line Business Practice Location Address:
STONY BROOK UNIVERSITY MEDICAL CTR
Provider Second Line Business Practice Location Address:
HSC-T-11-080, DEPT. PEDIATRICS
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:
631-444-8340
Provider Business Practice Location Address Fax Number:
631-444-6045
Provider Enumeration Date:
09/30/2008