Individual
RYAN C CORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
123 HOSPITAL AVE, GROUND FLOOR, DUBOIS, PA 15801
(814) 375-2070
(814) 375-3081
Mailing address
100 NICOLLS RD #271, HSC LEVEL 12-020, STONY BROOK, NY 11794
(631) 444-2599
(631) 759-2750
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
319359
NY
2084N0400X
Neurology Physician
Primary
OS024180
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104446503-0001
—
PA
01
—
7G4018
MC PTAN
PA
Enumeration date
04/04/2018
Last updated
04/30/2025
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