Provider Demographics
NPI:1225023963
Name:UNIVERSITY HOSPITAL STONY BROOK
Entity Type:Organization
Organization Name:UNIVERSITY HOSPITAL STONY BROOK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:MCCABE
Authorized Official - Last Name:MILLS
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:631-444-1820
Mailing Address - Street 1:43 SHORE RD
Mailing Address - Street 2:
Mailing Address - City:EAST SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-3920
Mailing Address - Country:US
Mailing Address - Phone:631-751-2106
Mailing Address - Fax:631-751-5796
Practice Address - Street 1:UNIVERSITY MEDICAL CENTER
Practice Address - Street 2:DIVISION OF CARDIOTHORACIC SURGERY T19,HSC, ROOM 080
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-0001
Practice Address - Country:US
Practice Address - Phone:631-444-1820
Practice Address - Fax:631-444-8963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-19
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF300862282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access