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Organization
STONY BROOK UNIVERSITY MEDICAL CENTER
Active
Organization
STONY BROOK UNIVERSITY MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JILL CAREN BERGSON MD (RESIDENT PHYSICIAN)
(917) 699-3460
Entity
Organization
Contact information
Practice address
2428 AVALON PINES DR, CORAM, NY 11727-5169
(917) 699-3460
Mailing address
2428 AVALON PINES DR, CORAM, NY 11727-5169
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/26/2007
Last updated
08/22/2020
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