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1427609130
MICHAEL STEPHAN
STONY BROOK, NY
NPI
1427609130
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: NY 023935-01)
Enumeration Date
2019-09-24
Last Update Date
2019-12-03
Business Address
MICHAEL STEPHAN
101 NICOLLS RD
STONY BROOK, NY 11794-0001
Phone number: 631-689-8333
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Mailing Address
MICHAEL STEPHAN
PO BOX 1559
STONY BROOK, NY 11790-0989
Phone number: 518-396-0515
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