Individual
DR. RAVEN DEVINCENZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
475 SEAVIEW AVE, STATEN ISLAND, NY 10305-3436
(718) 226-9175
(718) 226-8198
Mailing address
PO BOX 4652, WARREN, NJ 07059-0652
(718) 226-9175
(718) 226-8198
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
217324
NY
Other
Enumeration date
07/17/2006
Last updated
07/09/2007
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