Individual
MATHEW D EDNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
100 NICOLLS RD # LEVEL11, STONY BROOK, NY 11794-8111
(631) 444-8340
(631) 444-6045
Mailing address
PO BOX 1559, STONY BROOK, NY 11790-0989
(631) 444-8340
(631) 444-6045
Taxonomy
Speciality
Code
Description
License number
State
2080P0214X
Pediatric Pulmonology Physician
Primary
34-008778
OH
Other
Enumeration date
05/17/2007
Last updated
11/27/2013
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