Provider First Line Business Practice Location Address:
DEPARTMENT OF MEDICINE, HEALTH SCIENCE CENTER T16-020
Provider Second Line Business Practice Location Address:
STONY BROOK UNIVERSITY
Provider Business Practice Location Address City Name:
STONY BROOK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11794-8160
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-444-8478
Provider Business Practice Location Address Fax Number:
631-444-7546
Provider Enumeration Date:
06/15/2007