Individual
KEVIN DAHLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 NICOLLS RD, STONY BROOK, NY 11794-0001
(631) 444-4090
Mailing address
101 NICOLLS RD, STONY BROOK, NY 11794-0001
(631) 444-4090
Taxonomy
Speciality
Code
Description
License number
State
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
336766
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/07/2021
Last updated
06/24/2025
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