Provider First Line Business Practice Location Address:
STONY BROOK UNIVERSITY HOSPITAL
Provider Second Line Business Practice Location Address:
101 NICHOLS ROAD SBUH 8S ROOM 142
Provider Business Practice Location Address City Name:
STONY BROOK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11794-7080
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-444-8187
Provider Business Practice Location Address Fax Number:
631-444-6199
Provider Enumeration Date:
06/05/2019