Provider First Line Business Practice Location Address:
STONY BROOK UNIVERSITY MEDICAL CTR
Provider Second Line Business Practice Location Address:
DEPARTMENT OF MEDICINE L16
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:
631-444-2552
Provider Business Practice Location Address Fax Number:
631-444-2552
Provider Enumeration Date:
11/09/2005