Individual
RANDOLPH A. HENNIGAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D., M.D.
Contact information
Practice address
DEPARTMENT OF PATHOLOGY 101 NICOLLS RD BST-9T RM 140, STONY BROOK, NY 11794-1059
(770) 843-1990
Mailing address
DEPARTMENT OF PATHOLOGY 101 NICOLLS RD BST-9T RM 140, STONY BROOK, NY 11794-8691
(770) 843-1990
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
307626
NY
Other
Enumeration date
05/02/2006
Last updated
10/28/2020
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