OrganizationStony Brook Emergency Physicians, University Faculty Practice CorporatEmergency MedicineAllopathic & Osteopathic PhysiciansPractice AddressSuny @ Stony Brook, University Hospital, L4, Rm 515, Stony Brook, NY 11794-0001(631) 444-2406PECOS EnrollmentBased on the most recent information from CMS, provider Stony Brook Emergency Physicians, University Faculty Practice Corporat does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1265487672Provider TypeOrganizationFull NameStony Brook Emergency Physicians, University Faculty Practice CorporatSubpartNoEnumeration Date5/24/2006Last Updated10/3/2013Contact InformationPractice LocationPractice AddressSuny @ Stony Brook, University Hospital, L4, Rm 515, Stony Brook, NY 11794-0001Phone(631) 444-2406FaxUnlisted FaxMailing LocationMailing AddressPO Box 1554, Stony Brook, NY 11790-0988Phone(631) 444-2406FaxUnlisted FaxAuthorized OfficialNameHenry, Mark (Chair Person)Phone(631) 444-2406Provider TaxonomiesCodeDescriptionLicenseCode207P00000XPrimaryDescriptionEmergency MedicineAllopathic & Osteopathic PhysiciansLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerID01278739DescriptionMedicaidIssuerUnlistedNew York