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Dr. Matthew Van Raven, MD
Student in an Organized Health Care Education/Training Program in Stony Brook, New York
NPI 1013657253

Matthew Van Raven is a Student in an Organized Health Care Education/Training Program based in Stony Brook, NY. Matthew Van Raven practices in Stony Brook, NY and has the professional credentials of MD. The NPI Number for Matthew Van Raven is 1013657253 and holds a License No. (New York).

The current practice location address for Matthew Van Raven is 101 Nicolls Rd Rm 176, Stony Brook, NY and can be reached out via phone at 631-638-8517.

Location: 101 Nicolls Rd Rm 176, Stony Brook, NY, 11794-8430
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1013657253
Provider Name
Matthew Van Raven
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
101 Nicolls Rd Rm 176, Stony Brook, NY, 11794-8430
Phone Number
631-638-8517
Fax Number
Provider Enumeration Date
03/29/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
101 Nicolls Rd Rm 176
City
Stony Brook
State
New York
Zip
11794-8430
Phone Number
631-638-8517
Fax Number
person
Provider Business Mailing Address Details
Address
101 Nicolls Rd Rm 176
City
Stony Brook
State
New York
Zip
11794-8430
Phone Number
631-638-8517
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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