Individual provider · Type 1 NPI

Matthew Van Raven, MD

Student in an Organized Health Care Education/Training Program · Stony Brook, NY

NPI number 1013657253 Active

Practice location

101 Nicolls Rd Rm 176
Stony Brook, NY 11794-8430

Call (631) 638-8517 Map

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: 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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About NPI 1013657253

Matthew Van Raven, MD's National Provider Identifier is 1013657253, issued on Mar 29, 2022. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Stony Brook, NY. The record was last updated on Mar 29, 2022.