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Organization
STONY BROOK ANAESTHESIOLOGY, UNIVERSITY FACULTY PRACTICE CORPORATION
Active
Organization
STONY BROOK ANAESTHESIOLOGY, UNIVERSITY FACULTY PRACTICE CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TONG JOO GAN M.D. (CHAIR PERSON)
(631) 444-2976
Entity
Organization
Contact information
Practice address
SUNY @ STONY BROOK, HSC, L4, RM 060, STONY BROOK, NY 11794-0001
(631) 444-2976
Mailing address
PO BOX 1554, STONY BROOK, NY 11790-0988
(631) 444-2976
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00541644
—
NY
Enumeration date
05/24/2006
Last updated
05/05/2015
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