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Organization
MATHER FACULTY MEDICAL AFFILIATES, UNIVERSITY FACULTY PRACTICE CORP
Active
Organization
MATHER FACULTY MEDICAL AFFILIATES, UNIVERSITY FACULTY PRACTICE CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARLENE BRONSTORPH (DIRECTOR)
(516) 850-3999
Entity
Organization
Contact information
Practice address
1500 ROUTE 112 BLDG 5, PORT JEFFERSON STATION, NY 11776-8055
(631) 828-3400
(631) 828-3244
Mailing address
101 NICHOLLS ROAD, STONY BROOK, NY 11794-0001
(631) 689-8333
(631) 751-5971
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207RG0100X
Gastroenterology Physician
Primary
—
NULL
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Enumeration date
04/09/2026
Last updated
04/23/2026
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