Provider First Line Business Practice Location Address:
STONY BROOK UNIVERITY MEDICAL CENTER, SUNY @ SB
Provider Second Line Business Practice Location Address:
HSC LEVEL 16, ROOM 080
Provider Business Practice Location Address City Name:
STONY BROOK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11794-8167
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-444-8485
Provider Business Practice Location Address Fax Number:
631-444-2238
Provider Enumeration Date:
08/19/2008