Basic Information
| Provider Information | |||||||||
| NPI: | 1982871679 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PROBST | ||||||||
| FirstName: | STEPHEN | ||||||||
| MiddleName: | ALBERT | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | STONY BROOK UNIVERSITY HOSPITAL | ||||||||
| Address2: | MEDICAL STAFF OFFICE T-14 | ||||||||
| City: | STONY BROOK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117947148 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6314442754 | ||||||||
| FaxNumber: | 6314446031 | ||||||||
| Practice Location | |||||||||
| Address1: | STONY BROOK UNIVERSITY HOSPITAL | ||||||||
| Address2: | DEPT ANESTHESIOLOGY - HSC4 | ||||||||
| City: | STONY BROOK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117948480 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6314442976 | ||||||||
| FaxNumber: | 6314442907 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/12/2008 | ||||||||
| LastUpdateDate: | 05/12/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 60247351 | NY | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.