Stony Brook Family and Preventive Medicine, University Faculty Practic

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

STONY BROOK FAMILY AND PREVENTIVE MEDICINE, UNIVERSITY FACULTY PRACTIC

Practice address

Suny @ Stony Brook
HSC, L4, RM 050
Stony Brook, NY 11794-0001

Phone

(631) 444-2306

NPI assigned

May 23, 2006

Last updated

Jan 24, 2017By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Iris A Granek, M.D.

Title

Chairperson

Phone

(631) 444-2306

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 63

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lovedhi Aggarwal, MD

  • Geriatric Medicine (Family Medicine) Physician
  • East Setauket, NY
  • NPI 1760668933
  Medicare reassignment Care Compare group NPD
• Kimberly Patrice Barnaby, D.O.

  • Family Medicine Physician
  • Holbrook, NY
  • NPI 1952783045
  Medicare reassignment Care Compare group NPD
• Danielle Bellucci, NP-C

  • Adult Health Nurse Practitioner
  • Wading River, NY
  • NPI 1144655432
  Medicare reassignment Care Compare group NPD
• Robert Bobrow, M.D.

  • Family Medicine Physician
  • Patchogue, NY
  • NPI 1548204613
  Medicare reassignment Care Compare group NPD
• Ani A Bodoutchian, M.D.

  • Family Medicine Physician
  • West Babylon, NY
  • NPI 1508807447
  Medicare reassignment Care Compare group NPD
• Kamalpreet Buttar, M.D.

  • Family Medicine Physician
  • Lake Grove, NY
  • NPI 1669760419
  Medicare reassignment Care Compare group NPD
• Josephine Connolly-Schoonen, R.D.

  • Registered Dietitian
  • East Setauket, NY
  • NPI 1265476204
  Medicare reassignment Care Compare group NPD
• Lorraine Danowski, R.D.

  • Registered Dietitian
  • East Setauket, NY
  • NPI 1043251085
  Medicare reassignment Care Compare group NPD
• Susan Debevoise, D.O.

  • Family Medicine Physician
  • East Setauket, NY
  • NPI 1144258591
  Medicare reassignment Care Compare group NPD
• Jennifer Ehlers, DO

  • Emergency Medicine Physician
  • Commack, NY
  • NPI 1851595532
  Medicare reassignment Care Compare group NPD
• Allen Lawrence Fein, M.D.

  • Family Medicine Physician
  • Southampton, NY
  • NPI 1881672533
  Medicare reassignment Care Compare group NPD
• Nisha Manoj Ghayalod, MD

  • Addiction Medicine (Family Medicine) Physician
  • Southold, NY
  • NPI 1790361392
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485216000000",
    "number": "1982659470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1554",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117900988",
            "telephone_number": "631-444-2306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SUNY @ STONY BROOK",
            "address_2": "HSC, L4, RM 050",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117940001",
            "telephone_number": "631-444-2306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONY BROOK FAMILY AND PREVENTIVE MEDICINE, UNIVERSITY FACULTY PRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2017-01-24",
        "status": "A",
        "authorized_official_last_name": "GRANEK",
        "authorized_official_first_name": "IRIS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHAIRPERSON",
        "authorized_official_telephone_number": "631-444-2306",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stony Brook Dental Associates
• Stony Brook Dental Associates
• Stony Brook Dental PC
• Stony Brook Dermatology Associates, University Faculty Practice Corpor
• Stony Brook Emergency Physicians, University Faculty Practice Corporat
• Stony Brook Family Dentistry PC
• Stony Brook Fire Dist
• Stony Brook Holistic Wellness, LLC
• Stony Brook Hospital
• Stony Brook Internists, University Faculty Practice Corporation

• Family Medicine Physician in Stony Brook, NY
• Providers in Stony Brook, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.