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Organization
STONY BROOK PATHOLOGISTS, UNIVERSITY FACULTY PRACTICE CORPORATION
Active
Organization
STONY BROOK PATHOLOGISTS, UNIVERSITY FACULTY PRACTICE CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH SHROYER M.D. (CHAIR PERSON)
(631) 444-3000
Entity
Organization
Contact information
Practice address
SUNY @ STONY BROOK, BHS, L9, RM 140, STONY BROOK, NY 11790
(631) 444-3000
Mailing address
PO BOX 1554, STONY BROOK, NY 11790-0988
(631) 444-3000
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00821403
—
NY
Enumeration date
06/01/2006
Last updated
02/25/2015
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