Organization
NEUROLOGY ASSOCIATES OF STONY BROOK, UNIVERSITY FACULTY PRACTICE CORPO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARC W HALTERMAN M.D., PHD (PRESIDENT / DIRECTOR)
(631) 444-2599
Entity
Organization
Contact information
Practice address
101 NICOLLS RD RM 20, STONY BROOK, NY 11794-0001
(631) 444-2599
(631) 441-4744
Mailing address
PO BOX 1554, STONY BROOK, NY 11790-0988
(631) 444-8462
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01379102
—
NY
Enumeration date
05/24/2006
Last updated
09/26/2022
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