STONY BROOK RADIOLOGIC SERVICES PC (NPI# 1295780112) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295780112 |
| Entity Type | Organization |
| Organization Name | STONY BROOK RADIOLOGIC SERVICES PC |
| Practice Address |
2500 Nesconset Hwy Suite 15a Stony Brook NY 11790-2555 |
| Practice Telephone | 6317512900 |
| Practice Fax Number | 6317512051 |
| Mailing Telephone | 6317512900 |
| Mailing Fax Number | 6317512051 |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2007-11-02 |
| Authorized Official Name | MR. JOHN COLBERT (CFO) |
| Authorized Official Telephone | 6312310300 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 02284260 | 05 |
| Street Address |
2500 NESCONSET HWY SUITE 15A |
| City | STONY BROOK |
| State | NY |
| Zip Code | 11790-2555 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477556025 | Marc Yland | Anesthesiology | 2500 Nesconset Hwy, Bldg 24c, Stony Brook, NY 11790-2598 | 2005-05-27 |
| 1417471202 | Brandon M Henkowicz Dc, P.C. | Chiropractor | 2500 Nesconset Hwy, Stony Brook, NY 11790-2555 | 2017-08-02 |
| 1902345846 | Michael Fama | Physical Therapist | 2500 Nesconset Hwy, Bldg 22b, Stony Brook, NY 11790-2555 | 2017-02-13 |
| 1790149045 | Three Village Orthodontics | Dentist | 2500 Nesconset Hwy, Building 6-b, Stony Brook, NY 11790-2555 | 2016-04-12 |
| 1790156008 | Morgan Smyth | Physician Assistant | 2500 Nesconset Hwy, Stony Brook, NY 11790-2555 | 2015-10-13 |
| 1679964043 | Diana V Carney | Nurse Practitioner | 2500 Nesconset Hwy, Bldg 16, Suite 63, Stony Brook, NY 11790-2555 | 2015-02-06 |
| 1528469442 | Stoney Brook Dental PC | Dentist | 2500 Nesconset Hwy, Suite 11, Stony Brook, NY 11790-2555 | 2014-09-10 |
| 1235545732 | Robert Mosca Physical Therapy, Pllc | Specialist | 2500 Nesconset Hwy, Stony Brook, NY 11790-2555 | 2014-07-03 |
| 1841606605 | Shana Anthony | Physical Therapist | 2500 Nesconset Hwy, Stony Brook, NY 11790-2555 | 2014-07-01 |
| 1891136073 | Comprehensive Neurology of Long Island PC | Neuromusculoskeletal Medicine & OMM | 2500 Nesconset Hwy, Bldg 5b, Stony Brook, NY 11790-2555 | 2013-07-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649807678 | Ribu Mathew | Student in an Organized Health Care Education/Training Program | Health Science Center T16, Room 020, Stony Brook, NY 11790 | 2020-03-27 |
| 1538794821 | Chaoyang Qu | Student in an Organized Health Care Education/Training Program | 9 Syncamore Dr, Stonybrook, NY 11790 | 2020-03-06 |
| 1457814824 | Brain & Spine Surgery, P.C. | Neurological Surgery | 2500 Nesconset Hwy., Bldg 18c, Stony Brook, NY 11790 | 2019-04-11 |
| 1447759741 | Susan Cuccia | Registered Nurse | 40 Sheppard Lane, Stony Brook, NY 11790 | 2018-02-02 |
| 1972022234 | Carol M Doherty | Specialist | 7 Haskel Lane, Stony Brook, NY 11790 | 2017-09-18 |
| 1972021582 | Louren M Gonzales | Nurse Practitioner | 100 Nicolls Rd Hsc Level 4 Room 120, Hsc Level 4 Room 120, Stony Brook, NY 11790 | 2017-09-04 |
| 1043740954 | Asma Khattak | Behavior Technician | 90 Quaker Path, Stony Brook, NY 11790 | 2017-06-13 |
| 1427452846 | Christina Georgia | Registered Nurse | 36 Ivy League Lane, Stony Brook, NY 11790 | 2014-10-14 |
| 1124361654 | Mandeep Kainth | Student in an Organized Health Care Education/Training Program | Department of Medicine Hsc Level 16, 020, Suny Stony Brook, Stony Brook, NY 11790 | 2013-04-03 |
| 1922357144 | Audry M Luciano | Registered Nurse | 2500 Nesconset Hwy Bldg 23, Stony Brook, NY 11790 | 2012-09-04 |
| Find all providers in zip 11790 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023453495 | Daichi Hayashi | Radiology | Department of Radiology Stony Brook Medicine, Stony Brook, NY 11794 | 2013-04-30 |
| 1285994129 | Samantha Glass | Radiology | 101 Nichols Road, Department of Radiology, Stony Brook, NY 11794-7097 | 2012-05-25 |
| 1912266974 | Luboslav Woroch | Radiology | 100 Nichols Road, Hsc L4 Rm 120, Stony Brook, NY 11794-8460 | 2012-05-11 |
| 1720221369 | Lok Yun Sung | Radiology | 101 Nicolls Road, Department of Radiology, Hsc Level 4, Room 120, Stony Brook, NY 11794-8460 | 2009-04-13 |
| 1235378233 | Vladimir Sheynzon | Radiology | Stony Brook University Health Science Ctr, Department of Radiology, Hsc L4, Room 120, Stony Brook, NY 11794-0001 | 2009-02-13 |
| 1053579904 | Jennifer Faye Ripton-snyder | Radiology | Dept. of Radiology Stoney Brook Medicine, Hsc, Level 4, Room 120, Stony Brook, NY 11790 | 2008-05-28 |
| 1477730430 | Americo Saverio Fiore | Radiology | Hsc L4, Rm 120, Stony Brook, NY 11794-0001 | 2008-01-22 |
| 1447431796 | Hakan Sahin | Radiology | 101 Nicolls Rd Ste 120, Stony Brook, NY 11794-0001 | 2007-11-15 |
| 1023213725 | Mingqian Huang | Radiology | Nicolls Road and Health Sciences, Hsc Level 4 Room 120, Stony Brook, NY 11794-8460 | 2007-06-20 |
| 1235275496 | Dominic John Altieri | Radiology | 2500 Nesconset Hwy Bldg 15a, Stony Brook, NY 11790-2554 | 2007-01-29 |
| Find all providers in STONY BROOK | ||||
| City | STONY BROOK |
| Zip Code | 11790 |
Please comment or provide details below to improve the information on STONY BROOK RADIOLOGIC SERVICES PC.
| 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.