Provider First Line Business Practice Location Address:
HSC LEVEL 16, 020
Provider Second Line Business Practice Location Address:
DEPARTMENT OF MEDICINE, SUNY STONYBROOK
Provider Business Practice Location Address City Name:
STONY BROOK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11790-8160
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-444-7411
Provider Business Practice Location Address Fax Number:
631-444-2493
Provider Enumeration Date:
04/04/2013