STONY BROOK PREVENTIVE MEDICINE SERVICES, UNIV FCLTY PRACTICE CORP (NPI# 1164478749) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164478749 |
| Entity Type | Organization |
| Organization Name | STONY BROOK PREVENTIVE MEDICINE SERVICES, UNIV FCLTY PRACTICE CORP |
| Practice Address |
Suny @ Stony Brook Hsc, L3, Rm 086 Stony Brook NY 11794-0001 |
| Mailing Address |
Po Box 1554 Stony Brook NY 11790-0988 |
| Practice Telephone | 6314442189 |
| Mailing Telephone | 6314442189 |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2015-02-06 |
| Authorized Official Name | IRIS A GRANEK (PRESIDENT) |
| Authorized Official Telephone | 6314442189 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2083P0500X |
Preventive Medicine Specialization: Preventive Medicine/Occupational Environmental Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00994812 | 05 |
| Street Address |
SUNY @ STONY BROOK HSC, L3, RM 086 |
| City | STONY BROOK |
| State | NY |
| Zip Code | 11794-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982659470 | Stony Brook Family and Preventive Medicine, University Faculty Practic | Family Medicine | Suny @ Stony Brook, Hsc, L4, Rm 050, Stony Brook, NY 11794-0001 | 2006-05-23 |
| 1295778371 | Stony Brook Internists, University Faculty Practice Corporation | Internal Medicine | Suny @ Stony Brook, Hsc, L16, Rm 020, Stony Brook, NY 11794-0001 | 2006-06-14 |
| 1578502100 | Stony Brook Internists, University Faculty Practice Corporation | Internal Medicine | Suny @ Stony Brook, Hsc, L16, Rm 020, Stony Brook, NY 11794-0001 | 2006-06-06 |
| 1265471809 | Stony Brook Internists, University Faculty Practice Corporation | Internal Medicine | Suny @ Stony Brook, Hsc, L16, Rm 020, Stony Brook, NY 11794-0001 | 2006-06-06 |
| 1497794077 | Stony Brook Internists, University Faculty Practice Corporation | Internal Medicine | Suny @ Stony Brook, Hsc, L16, Rm 020, Stony Brook, NY 11794-0001 | 2006-06-06 |
| 1659310241 | Stony Brook Internists, University Faculty Practice Corporation | Internal Medicine | Suny @ Stony Brook, Hsc, L16, Rm 020, Stony Brook, NY 11794-0001 | 2006-06-06 |
| 1215976337 | Stony Brook Internists, University Faculty Practice Corporation | Internal Medicine | Suny @ Stony Brook, Hsc, L16, Rm 020, Stony Brook, NY 11794-0001 | 2006-06-05 |
| 1104865229 | Stony Brook Internists, University Faculty Practice Corporation | Internal Medicine | Suny @ Stony Brook, Hsc, L16, Rm 020, Stony Brook, NY 11794-0001 | 2006-06-05 |
| 1356380471 | Stony Brook Internists, University Faculty Practice Corporation | Internal Medicine | Suny @ Stony Brook, Hsc, L16, Rm 020, Stony Brook, NY 11794-0001 | 2006-06-05 |
| 1912944794 | Stony Brook Pathologists, University Faculty Practice Corporation | Pathology | Suny @ Stony Brook, Bhs, L9, Rm 140, Stony Brook, NY 11790 | 2006-06-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619506714 | Ryan John Kottmeier | Physician Assistant | 101 Nicolls Road Suny Stony Brook Hospital, Dept of Orthopedics Hsc T18, Room 080, Stony Brook, NY 11794 | 2020-04-02 |
| 1699302109 | Michael Trentalange | Student in an Organized Health Care Education/Training Program | Department of Surgery, Health Sciences Center Level 19, Room 030, Stony Brook, NY 11794 | 2020-03-25 |
| 1164985156 | Lauren Kate Harris | Student in an Organized Health Care Education/Training Program | Stony Brook Medicine, Department of Ob/gyn, Hsc T9, 101 Nicolls Road, Stony Brook, NY 11794 | 2019-04-08 |
| 1851851448 | Kathy Tin | Student in an Organized Health Care Education/Training Program | Dept of Medicine Hsc 16 Suny Stony Brook Hospital, Stony Brook, NY 11794 | 2019-03-21 |
| 1174083703 | Arham Khan | Student in an Organized Health Care Education/Training Program | Dept of Medicine Hsc Level 16, Suny Stony Brook Hosp, Stony Brook, NY 11794 | 2019-03-20 |
| 1396221982 | Aman Bhojani | Student in an Organized Health Care Education/Training Program | Suny At Stony Brook Dental School, South Drive, Stony Brook, NY 11794 | 2018-07-17 |
| 1699265629 | Belliny Phaeton | Student in an Organized Health Care Education/Training Program | Stony Brook Children's Hospital, Hsc T-11, Room 040, Stony Brook, NY 11794 | 2018-05-15 |
| 1629568969 | Rachel Herold | Student in an Organized Health Care Education/Training Program | Stony Brook Children's Department of Pediatrics, Hsc T-11, Room 040, Stony Brook, NY 11794 | 2018-05-11 |
| 1598254419 | Nora Ann Diraimondo | Nurse Practitioner | Sb Hospital 101 Nicolls Road, Department of Medicine, Stony Brook, NY 11794 | 2018-05-07 |
| 1386140705 | Ryan Christopher Corn | Student in an Organized Health Care Education/Training Program | Dept. of Internal Medicine, Hsc Level 16-020, Suny Stony Brook, Stony Brook, NY 11794 | 2018-04-04 |
| Find all providers in zip 11794 | ||||
| Taxonomy Code | 2083P0500X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Preventive Medicine/Occupational Environmental Medicine |
| A preventive medicine physician who specializes in preventive medicine/occupational-environmental medicine, which is focused on protecting the population from occupational and environmental conditions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487842357 | David G Graham | Preventive Medicine | 2500 Nesconset Hwy Bldg 16c, Stony Brook, NY 11790-2563 | 2007-10-04 |
| 1609163872 | Farah Haq | Preventive Medicine | 2500 Nesconset Hwy, Stony Brook, NY 11790-2555 | 2011-07-07 |
| 1457659062 | Charles Gian Dipierro | Preventive Medicine | 100 Nicolls Rd, Suny Stony Brook, Dept. of Preventive Medicine, Hsc L3, Stony Brook, NY 11794-0001 | 2011-03-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700343993 | Steven Bernard Markowitz | Preventive Medicine | Queens College - 65-30 Kissena Blvd, Commoner Center- Remsen 311, Queens, NY 11367 | 2019-02-25 |
| 1659876092 | Healthstat Onsite Hbo Hauppauge | Preventive Medicine | 300 New Hwy, Hauppauge, NY 11788-2017 | 2018-03-28 |
| 1740785187 | Healthstat Onsite Hbo Ny | Preventive Medicine | 1100 Avenue of The Americas, New York, NY 10036-6712 | 2018-03-28 |
| 1033622857 | Russell Karp Md Functional Medicine Pllc | Preventive Medicine | 23 Croft Rd, Poughkeepsie, NY 12603-4917 | 2017-11-15 |
| 1730626748 | Selftest Inc. | Preventive Medicine | 18 Beach Ave, Northport, NY 11768-2803 | 2017-01-28 |
| 1962842336 | David Pratt | Preventive Medicine | 999 Grooms Rd, Rexford, NY 12148-1306 | 2013-07-01 |
| 1760723969 | Healthstat On-site Clinic/farm Family | Preventive Medicine | 344 Route 9w, Glenmont, NY 12077-2910 | 2013-03-13 |
| 1508124553 | Faculty Practice Associates Mount Sinai School of Medicine | Preventive Medicine | 345 E 102nd St Suite 215, New York, NY 10029-5611 | 2012-04-27 |
| 1134378896 | Susan M. Daum | Preventive Medicine | 16 E 96th St, 5a, New York, NY 10128-0753 | 2008-09-17 |
| 1851551519 | Isadora Guggenheim | Preventive Medicine | 8 Rockland Place, Nyack, NY 10960 | 2008-06-16 |
| Find all providers with the same taxonomy | ||||
| City | STONY BROOK |
| Zip Code | 11794 |
Please comment or provide details below to improve the information on STONY BROOK PREVENTIVE MEDICINE SERVICES, UNIV FCLTY PRACTICE CORP.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.