Provider Demographics
NPI:1720398209
Name:CAVANAGH, MARY F (MD,MPH)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:F
Last Name:CAVANAGH
Suffix:
Gender:F
Credentials:MD,MPH
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Mailing Address - Street 1:DEPT. OF PREVMENTIVE MEDICINE, HSC L-3, RM 086
Mailing Address - Street 2:STONY BROOK UNIVERSITY SCHOOL OF MEDICINE
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-8036
Mailing Address - Country:US
Mailing Address - Phone:631-444-8267
Mailing Address - Fax:631-444-7525
Practice Address - Street 1:DEPT. OF PREVMENTIVE MEDICINE, HSC L-3, RM 086
Practice Address - Street 2:STONY BROOK UNIVERSITY SCHOOL OF MEDICINE
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-8036
Practice Address - Country:US
Practice Address - Phone:631-444-8267
Practice Address - Fax:631-444-7525
Is Sole Proprietor?:No
Enumeration Date:2010-10-18
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2107882083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine