Stony Brook Family And Preventive Medicine, University Faculty Practic | |
Suny @ Stony Brook Hsc, L4, Rm 050 Stony Brook NY 11794-0001 | |
(631) 444-2306 | |
Not Available |
Full Name | Stony Brook Family And Preventive Medicine, University Faculty Practic |
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Speciality | Family Medicine |
Location | Suny @ Stony Brook, Stony Brook, New York |
Authorized Official Name and Position | Iris A Granek (CHAIRPERSON) |
Authorized Official Contact | 6314442306 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Stony Brook Family And Preventive Medicine, University Faculty Practic Po Box 1554 Stony Brook NY 11790-0988 Ph: (631) 444-2306 | Stony Brook Family And Preventive Medicine, University Faculty Practic Suny @ Stony Brook Hsc, L4, Rm 050 Stony Brook NY 11794-0001 Ph: (631) 444-2306 |
NPI Number | 1982659470 |
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Provider Enumeration Date | 05/23/2006 |
Last Update Date | 01/24/2017 |
Medicare PECOS PAC ID | 7113816273 |
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Medicare Enrollment ID | O20040315000903 |
Identifier | Type | State | Issuer |
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1982659470 | NPI | - | NPPES |
00549880 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Kevin J Schiller |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1710901921 PECOS PAC ID: 4486648805 Enrollment ID: I20040409000089 |
Provider Name | Vivica D Vollmer |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1073558995 PECOS PAC ID: 5092793638 Enrollment ID: I20040710000217 |
Provider Name | Ani A Bodoutchian |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1508807447 PECOS PAC ID: 9133163348 Enrollment ID: I20050617000266 |
Provider Name | Raja A Jaber |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1417999764 PECOS PAC ID: 8224038609 Enrollment ID: I20070109000277 |
Provider Name | Sultana Y Rahman |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1386601359 PECOS PAC ID: 4880798206 Enrollment ID: I20070324000018 |
Provider Name | Kathleen H Scarbrough |
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Provider Type | Practitioner - Preventive Medicine |
Provider Identifiers | NPI Number: 1417057308 PECOS PAC ID: 7113067133 Enrollment ID: I20091222000493 |
Provider Name | Donna I Meltzer |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1144258500 PECOS PAC ID: 1355478538 Enrollment ID: I20100420000381 |
Provider Name | Howard R Sussman |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1497799571 PECOS PAC ID: 3476556655 Enrollment ID: I20100420000642 |
Provider Name | Gerald Kelly |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1659308492 PECOS PAC ID: 9931102118 Enrollment ID: I20100421000571 |
Provider Name | Jedan Phillips |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1659317956 PECOS PAC ID: 7416084413 Enrollment ID: I20100423000010 |
Provider Name | Richard V Murdocco |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1841234093 PECOS PAC ID: 0143357152 Enrollment ID: I20100423000028 |
Provider Name | Susan Debevoise |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1144258591 PECOS PAC ID: 8527195452 Enrollment ID: I20100423000360 |
Provider Name | Katherine G Wightman |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1467489880 PECOS PAC ID: 1456488394 Enrollment ID: I20100423000475 |
Provider Name | Josephine Connolly-schoonen |
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Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1265476204 PECOS PAC ID: 4688701527 Enrollment ID: I20100423000542 |
Provider Name | Lorraine Danowski |
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Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1043251085 PECOS PAC ID: 8224165170 Enrollment ID: I20100423000656 |
Provider Name | Robert Bobrow |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1548204613 PECOS PAC ID: 9234266917 Enrollment ID: I20100429000131 |
Provider Name | Jarid S Pachter |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1750514022 PECOS PAC ID: 7315077294 Enrollment ID: I20100621000238 |
Provider Name | Lovedhi Aggarwal |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1760668933 PECOS PAC ID: 3678627569 Enrollment ID: I20110104000779 |
Provider Name | Allen Lawrence Fein |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1881672533 PECOS PAC ID: 8820279367 Enrollment ID: I20110216001046 |
Provider Name | Jeanine M Morelli |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1447354659 PECOS PAC ID: 1153503677 Enrollment ID: I20110304000378 |
Provider Name | Ghazal Sinha |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1356661649 PECOS PAC ID: 4688992068 Enrollment ID: I20150415000796 |
Provider Name | Kamalpreet S Buttar |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1669760419 PECOS PAC ID: 6800102567 Enrollment ID: I20150826002308 |
Provider Name | Danielle Bellucci |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1144655432 PECOS PAC ID: 2567763766 Enrollment ID: I20151211002052 |
Provider Name | Amanda Pero |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1306151378 PECOS PAC ID: 3274835392 Enrollment ID: I20160106002806 |
Provider Name | Farah Haq |
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Provider Type | Practitioner - Preventive Medicine |
Provider Identifiers | NPI Number: 1609163872 PECOS PAC ID: 2769773225 Enrollment ID: I20160614001535 |
Provider Name | Sarah A Cheek |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1457761959 PECOS PAC ID: 0143592253 Enrollment ID: I20170824002183 |
Provider Name | Yuri T Jadotte |
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Provider Type | Practitioner - Preventive Medicine |
Provider Identifiers | NPI Number: 1770800674 PECOS PAC ID: 3375899966 Enrollment ID: I20180712001405 |
Provider Name | Kimberly P Barnaby |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1952783045 PECOS PAC ID: 3678827458 Enrollment ID: I20181114000981 |
Provider Name | Melissa M Feraca |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1982263091 PECOS PAC ID: 7214264977 Enrollment ID: I20190805000542 |
Provider Name | Sritha R Rajupet |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1285991596 PECOS PAC ID: 2668743733 Enrollment ID: I20200831000133 |
Provider Name | Kelly A O'toole |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1033710009 PECOS PAC ID: 8123433323 Enrollment ID: I20210222001402 |
Provider Name | Maryta J Marzano |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1306499637 PECOS PAC ID: 4385051796 Enrollment ID: I20210401000333 |
Provider Name | Mariam M Kirvalidze |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1508353517 PECOS PAC ID: 1355695966 Enrollment ID: I20210630001365 |
Provider Name | Astha Muttreja |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1710364005 PECOS PAC ID: 8022345792 Enrollment ID: I20220519001975 |
Provider Name | April A Castillo |
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Provider Type | Practitioner - Preventive Medicine |
Provider Identifiers | NPI Number: 1619314259 PECOS PAC ID: 3173805520 Enrollment ID: I20220728001303 |
Provider Name | Michael R Epifania |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1548720030 PECOS PAC ID: 1850775768 Enrollment ID: I20220826000235 |
Provider Name | Kimberley C Nazario |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1598412660 PECOS PAC ID: 9032588264 Enrollment ID: I20221212000314 |
Provider Name | Sally Anne J Rexach |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1609123959 PECOS PAC ID: 7012380603 Enrollment ID: I20230301002036 |
Provider Name | Jake A Hunter |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1467080770 PECOS PAC ID: 2365897451 Enrollment ID: I20231010001040 |
Provider Name | Kimberly A Hsu |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1497382287 PECOS PAC ID: 4789001157 Enrollment ID: I20231019002618 |
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