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Organization

MATHER FACULTY MEDICAL AFFILIATES, UNIVERSITY FACULTY PRACTICE CORP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SHARLENE BRONSTORPH (DIRECTOR)
(516) 850-3999
Entity
Organization

Contact information

Practice address
1500 ROUTE 112 BLDG 5, PORT JEFFERSON STATION, NY 11776-8055
(631) 828-3400
(631) 828-3244
Mailing address
101 NICHOLLS ROAD, STONY BROOK, NY 11794-0001
(631) 689-8333
(631) 751-5971

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
207RG0100X
Gastroenterology Physician
Primary

Other

Enumeration date
04/09/2026
Last updated
04/23/2026
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