Organization
UFPC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK TALAMINI (CHAIRMAN OF DEPARTMENT OF SURGERY)
(631) 444-7875
Entity
Organization
Contact information
Practice address
23 S HOWELL AVE, STONY BROOK MEDICINE - VASCULAR SURGERY, CENTEREACH, NY 11720-4445
(631) 638-1670
Mailing address
PO BOX 1554, STONY BROOK, NY 11790-0988
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
09/07/2016
Last updated
09/07/2016
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