STONY BROOK FAMILY AND PREVENTIVE MEDICINE, UNIVERSITY FACULTY PRACTIC (NPI# 1982659470) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982659470 |
| Entity Type | Organization |
| Organization Name | STONY BROOK FAMILY AND PREVENTIVE MEDICINE, UNIVERSITY FACULTY PRACTIC |
| Practice Address |
Suny @ Stony Brook Hsc, L4, Rm 050 Stony Brook NY 11794-0001 |
| Mailing Address |
Po Box 1554 Stony Brook NY 11790-0988 |
| Practice Telephone | 6314442306 |
| Mailing Telephone | 6314442306 |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2017-01-24 |
| Authorized Official Name | DR. IRIS A GRANEK (CHAIRPERSON) |
| Authorized Official Telephone | 6314442306 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00549880 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | STONY BROOK FAMILY AND PREVENTIVE MEDICINE, UNIVERSITY FACULTY PRACTICE CORPORATION | Health Sciences Ctr L5 Rm 048, Stony Brook University, Stony Brook, New York 11794 |
| Street Address |
SUNY @ STONY BROOK HSC, L4, RM 050 |
| City | STONY BROOK |
| State | NY |
| Zip Code | 11794-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1821035601 | Stony Brook Internists, University Faculty Practice Corporation | Internal Medicine | Suny @ Stony Brook, Hsc, L16, Rm 020, Stony Brook, NY 11794-0001 | 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 | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134515299 | Sabina Rebis | Family Medicine | Stony Brook University Hospital Hsc, Hsc 4-050, Stony Brook, NY 11794 | 2015-04-15 |
| 1598856189 | Frederick E Caston | Family Medicine | 7 Alicia Ct, Stony Brook, NY 11790-3380 | 2006-09-27 |
| 1164525457 | Gretchen L Mockler | Family Medicine | Stony Brook Family Medicine, Hsc L4 Room 050, Stony Brook, NY 11794-0001 | 2006-09-05 |
| 1699783548 | Vincent Thomas Geraci | Family Medicine | 1501 Stony Brook Rd, Stony Brook, NY 11790-2212 | 2006-08-04 |
| 1033103312 | William James Robbins | Family Medicine | 4 Meadow Dr, Stony Brook, NY 11790-2810 | 2005-09-01 |
| 1114920360 | Kulsoom Shah | Family Medicine | 1 Stadium Rd,student Health Center,stonybrook Univ, Stony Brook, NY 11794-0001 | 2005-05-23 |
| 1083617112 | Sujatha Konnanath Palat | Family Medicine | 1stadium Rd,student Health Service, Stonybrook Univ, Stony Brook, NY 11794-3191 | 2005-05-23 |
| 1790245132 | In Touch With Your Health Medical PC | Family Medicine | 1501 Stony Brook Rd, Stony Brook, NY 11790-2212 | 2019-03-21 |
| 1891217774 | Marisa Massaro | Family Medicine | 207 Hallock Rd, Stony Brook, NY 11790-3033 | 2017-07-12 |
| 1306266952 | Xin Fu Lin | Family Medicine | 100 Nicolls Rd, Stony Brook, NY 11790 | 2014-04-22 |
| Find all providers in STONY BROOK | ||||
| City | STONY BROOK |
| Zip Code | 11794 |
Please comment or provide details below to improve the information on STONY BROOK FAMILY AND PREVENTIVE MEDICINE, UNIVERSITY FACULTY PRACTIC.
| 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.