Organization
STONY BROOK DERMATOLOGY ASSOCIATES, UNIVERSITY FACULTY PRACTICE CORPOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EVAN JONES M.D. (CHAIR PERSON)
(631) 444-7597
Entity
Organization
Contact information
Practice address
SUNY @ STONY BROOK, HSC, L16, RM 060, STONY BROOK, NY 11794-0001
(631) 444-7597
Mailing address
PO BOX 1554, STONY BROOK, NY 11790-0988
(631) 444-7597
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01193984
—
NY
Enumeration date
05/24/2006
Last updated
01/22/2015
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