Provider First Line Business Practice Location Address:
STONY BROOK UNIVERSITY MEDICAL CENTER
Provider Second Line Business Practice Location Address:
DEPARTMENT OF PSYCHIATRY,HSC,T-10,ROOM 020
Provider Business Practice Location Address City Name:
STONY BROOK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11790
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-444-2884
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/08/2010