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Individual

CAROL ANN RAYNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
65 CHAPEL RD, WACCABUC, NY 10597-1001
(914) 763-8723
Mailing address
65 CHAPEL RD, WACCABUC, NY 10597-1001

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
042522
CT
207R00000X
Internal Medicine Physician
Primary
191333
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01502230
NY
01
194AB1
BLUE CROSS DELUXE
NY
01
5915020
AETNA NON HMO
NY
Enumeration date
01/12/2006
Last updated
02/12/2013
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