Basic Information
| Provider Information | |||||||||
| NPI: | 1720491475 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | STONYBROOK UNIVERSITY HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2 GLATTER LN | ||||||||
| Address2: | |||||||||
| City: | SOUTH SETAUKET | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117201032 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6317308481 | ||||||||
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| Practice Location | |||||||||
| Address1: | STONY BROOK UNIVERSITY HOSPITAL | ||||||||
| Address2: | |||||||||
| City: | STONY BROOK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117940001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6314441066 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/10/2014 | ||||||||
| LastUpdateDate: | 06/10/2014 | ||||||||
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| AuthorizedOfficialLastName: | WILLIAM | ||||||||
| AuthorizedOfficialFirstName: | LAWSON | ||||||||
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| AuthorizedOfficialTitleorPosition: | CHIEF OF CARDIOLOGY | ||||||||
| AuthorizedOfficialTelephone: | 6314441066 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 305509 | NY | Y | Hospitals | General Acute Care Hospital |
No ID Information.