Provider Demographics
NPI:1710380118
Name:STONY BROOK UNIVERSITY
Entity Type:Organization
Organization Name:STONY BROOK UNIVERSITY
Other - Org Name:STONY BROOK UNIVERSITY SPORTS MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:STUART
Authorized Official - Middle Name:B
Authorized Official - Last Name:CHERNEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-632-6000
Mailing Address - Street 1:TOLL DR BLDG 39
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-0001
Mailing Address - Country:US
Mailing Address - Phone:631-632-6000
Mailing Address - Fax:
Practice Address - Street 1:TOLL DR BLDG 39
Practice Address - Street 2:
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-0001
Practice Address - Country:US
Practice Address - Phone:631-632-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-30
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty