Individual provider · Type 1 NPI

Tyana Raynor, DO

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

NPI number 1346687811 Active

Practice location

1300 Roanoke Ave
Riverhead, NY 11901-2031

Call (631) 548-6446 Map

Fax (631) 727-0772

Mailing address

1000 Montauk Hwy
West Islip, NY 11795-4927

Specialties and licenses

TaxonomyCodeLicense
Pediatric Radiology Physician 2085P0229XOS18820 (FL)
Diagnostic Radiology Physician 2085R0202X05370 (KY)
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 1346687811

Tyana Raynor, DO's National Provider Identifier is 1346687811, issued on May 23, 2013. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Riverhead, NY. The record was last updated on Sep 28, 2023.