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Organization

STONY BROOK RADIOLOGY, UNIVERSITY FACULTY PRACTICE CORPORATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ELAINE S GOULD M.D. (CHAIR PERSON)
(631) 444-3452
Entity
Organization

Contact information

Practice address
SUNY AT STONY BRK, HSC, L4, RM 120, STONY BROOK, NY 11794-8460
(631) 444-3452
Mailing address
PO BOX 1554, STONY BROOK, NY 11790-0988
(631) 444-3452

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
2085R0204X
Vascular & Interventional Radiology Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00549133
NY
Enumeration date
05/24/2006
Last updated
07/06/2023
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