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General NPI Number Information
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NPI Number | 1811226657
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Entity Type | Organization
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Legal Business Name | STONY BROOK UNIVERSITY MEDICAL CENTER
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Dates
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Enumeration Date | 12/07/2009
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Last Update Date | 12/07/2009
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Provider Practice Location Address
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Address Line | 2401 VISTA VIEW DR
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City | FARMINGVILLE
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State | NY
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Zip | 11738-3029
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Country | US
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Telephone | 631-793-1177
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Fax |
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Provider Business Mailing Address
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Address Line | 2401 VISTA VIEW DR
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City | FARMINGVILLE
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State | NY
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Zip | 11738-3029
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Country | US
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Telephone | 631-793-1177
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Fax |
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Authorized Official
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Title or Position | NURSE MANAGER
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Name | JERALYN SIGWART
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Credential |
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Telephone | 631-444-1171
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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 | 605601
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License Number State | NY
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