Provider Demographics
NPI:1386140705
Name:CORN, RYAN C (DO)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:C
Last Name:CORN
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Gender:M
Credentials:DO
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Mailing Address - Street 1:100 NICOLLS RD #271
Mailing Address - Street 2:HSC LEVEL 12-020
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794
Mailing Address - Country:US
Mailing Address - Phone:631-444-2599
Mailing Address - Fax:631-759-2750
Practice Address - Street 1:123 HOSPITAL AVE
Practice Address - Street 2:GROUND FLOOR
Practice Address - City:DUBOIS
Practice Address - State:PA
Practice Address - Zip Code:15801
Practice Address - Country:US
Practice Address - Phone:814-375-2070
Practice Address - Fax:814-375-3081
Is Sole Proprietor?:No
Enumeration Date:2018-04-04
Last Update Date:2024-12-09
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Provider Licenses
StateLicense IDTaxonomies
NY3193592084N0400X
PAOS0241802084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology