Provider First Line Business Practice Location Address:
BST9, ROOM 140, DEPARTMENT OF PATHOLOGY
Provider Second Line Business Practice Location Address:
STONY BROOK UNIVERSITY MEDICAL 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:
11794-8691
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-444-3069
Provider Business Practice Location Address Fax Number:
631-444-3424
Provider Enumeration Date:
07/18/2006