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General NPI Number Information
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NPI Number | 1225023963
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Entity Type | Organization
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Legal Business Name | UNIVERSITY HOSPITAL STONY BROOK
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Dates
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Enumeration Date | 09/19/2005
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Last Update Date | 06/17/2008
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Provider Practice Location Address
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Address Line | UNIVERSITY MEDICAL CENTER DIVISION OF CARDIOTHORACIC SURGERY T19,HSC, ROOM 080
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City | STONY BROOK
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State | NY
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Zip | 11794-0001
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Country | US
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Telephone | 631-444-1820
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Fax | 631-444-8963
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Provider Business Mailing Address
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Address Line | 43 SHORE RD
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City | EAST SETAUKET
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State | NY
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Zip | 11733-3920
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Country | US
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Telephone | 631-751-2106
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Fax | 631-751-5796
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Authorized Official
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Title or Position | SENIOR NURSE PRACTITIONER
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Name | MRS. BARBARA MCCABE MILLS
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Credential | NP
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Telephone | 631-444-1820
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | F300862
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License Number State | NY
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