Provider First Line Business Practice Location Address:
NEW YORK SPINE & BRAIN SURGERY HSC T12 RM 080
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STONY BROOK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11794-4235
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-444-1116
Provider Business Practice Location Address Fax Number:
631-444-1535
Provider Enumeration Date:
04/05/2006