Provider First Line Business Practice Location Address:
STONY BROOK UNIV MED ICAL CTR
Provider Second Line Business Practice Location Address:
T12, 080 HEALTH SCIENCE CENTER
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:
631-444-1210
Provider Business Practice Location Address Fax Number:
631-444-1535
Provider Enumeration Date:
06/08/2008