Organization
STONY BROOK PATHOLOGISTS, UNIVERSITY FACULTY PRACTICE CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH SHROYER M.D. (CHAIR PERSON)
(631) 444-3000
Entity
Organization
Contact information
Practice address
SUNY @ STONY BROOK, BHS, L9, RM 140, STONY BROOK, NY 11790
(631) 444-3000
Mailing address
PO BOX 1554, STONY BROOK, NY 11790-0988
(631) 444-3000
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00821403
—
NY
Enumeration date
06/01/2006
Last updated
02/25/2015
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