STONY BROOK UNIVERSITY MEDICAL CENTER (NPI# 1487850251) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487850251 |
| Entity Type | Organization |
| Organization Name | STONY BROOK UNIVERSITY MEDICAL CENTER |
| Practice Address |
2428 Avalon Pines Dr Coram NY 11727-5169 |
| Practice Telephone | 9176993460 |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. JILL CAREN BERGSON (RESIDENT PHYSICIAN) |
| Authorized Official Telephone | 9176993460 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811226657 | Stony Brook University Medical Center | General Acute Care Hospital | 2401 Vista View Dr, Farmingville, NY 11738-3029 | 2009-12-07 |
| 1427497304 | Stony Brook University Medical Center | Clinic/Center | 6 Technology Dr, Setauket, NY 11733-4079 | 2013-06-24 |
| 1447410956 | Stony Brook University Medical Center | General Acute Care Hospital | 100 Nicholls Rd, Stony Brook, NY 11794-0001 | 2008-06-10 |
| 1679626063 | Stony Brook University Medical Center | General Acute Care Hospital | Nicolls Rd, Stony Brook, NY 11794-0001 | 2007-01-19 |
| Street Address |
2428 AVALON PINES DR |
| City | CORAM |
| State | NY |
| Zip Code | 11727-5169 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649891490 | Ocean Acupuncture PC | Acupuncturist | 1970-6, Coram, NY 11727 | 2020-05-04 |
| 1982254058 | Lynanne Helen Bopp | Student in an Organized Health Care Education/Training Program | 3600 Ny- 112, Coram, NY 11727 | 2019-09-19 |
| 1427604206 | Embrace Your Energy, LLC | Specialist/Technologist | 300 Wincoram Way, Coram, NY 11727 | 2019-08-16 |
| 1457842247 | Hina Ghani | Pharmacist | 1710 Ny-112, Coram, NY 11727 | 2018-05-29 |
| 1093219636 | James Brian Rochford Jr. | Social Worker | 1980 Ny Route 112, Coram, NY 11727 | 2018-03-20 |
| 1902324502 | Shanell Lovette Woodley | Registered Nurse | Country Club Drive, Apt 10 D, Coram, NY 11727 | 2017-09-03 |
| 1730606377 | Emani, Inc. | Respite Care | 5 Hagen Ct., Coram, NY 11727 | 2017-08-24 |
| 1124553292 | Zhimin Lin | Dentist | 1879 Ny-112, Coram, NY 11727 | 2017-04-26 |
| 1780125286 | Jennifer Zielinski | Specialist | 18 Cammann Road, Coram, NY 11727 | 2017-03-16 |
| 1194271486 | Kimberly Kowalczyk | Psychologist | 28 Hawkins Path, Coram, NY 11727 | 2016-08-28 |
| Find all providers in zip 11727 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295354744 | Susana Barros-sierra | Student in an Organized Health Care Education/Training Program | 60 Chardonnay Dr, Coram, NY 11727-2433 | 2020-04-14 |
| 1982254058 | Lynanne Helen Bopp | Student in an Organized Health Care Education/Training Program | 3600 Ny- 112, Coram, NY 11727 | 2019-09-19 |
| 1215330717 | Hyon Bae | Student in an Organized Health Care Education/Training Program | 3600 Rte 112, Coram, NY 11727 | 2014-09-29 |
| 1073871430 | Anastasia Plaunova | Student in an Organized Health Care Education/Training Program | 21 Country Club Dr, Apt. I, Coram, NY 11727-3416 | 2012-04-24 |
| 1093080236 | Laura Cheney | Student in an Organized Health Care Education/Training Program | 19 Country Club Dr, Apt B, Coram, NY 11727-3414 | 2012-03-21 |
| 1760081277 | Ally Danielle Liff | Student in an Organized Health Care Education/Training Program | 3600 Route 112, Coram, NY 11727-4116 | 2020-10-26 |
| 1407456940 | Imani Alexia Nunez | Student in an Organized Health Care Education/Training Program | 3600 Route 112, Coram, NY 11727-4116 | 2020-10-26 |
| 1508465469 | Toni Deleonardis | Student in an Organized Health Care Education/Training Program | 7 Hayes Ln, Coram, NY 11727-3081 | 2020-10-21 |
| 1144834979 | Christina Cona | Student in an Organized Health Care Education/Training Program | 3600 Route 112, Coram, NY 11727-4116 | 2020-08-31 |
| 1225648033 | Brianna Gallina | Student in an Organized Health Care Education/Training Program | 3600 Route 112, Coram, NY 11727-4116 | 2020-08-06 |
| Find all providers in CORAM | ||||
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| 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.