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Organization
STONY BROOK CHILDREN'S SERVICE, UNIVERSITY FACULTY PRACTICE CORPORATIO
Active
Organization
STONY BROOK CHILDREN'S SERVICE, UNIVERSITY FACULTY PRACTICE CORPORATIO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARGARET MCGOVERN M.D. (CHAIR PERSON)
(631) 444-1362
Entity
Organization
Contact information
Practice address
SUNY @ STONY BROOK, HSC, L11, RM 020, STONY BROOK, NY 11794-0001
(631) 444-1362
Mailing address
PO BOX 1554, STONY BROOK, NY 11790-0988
(631) 444-1362
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02291087
—
NY
Enumeration date
05/26/2006
Last updated
02/27/2015
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