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Individual

LUCY RUANGVORAVAT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
800 HOWARD AVE FL 3, NEW HAVEN, CT 06519-1369
(203) 785-2572
Mailing address
251 SALINA MEADOWS PKWY, STE 100, SYRACUSE, NY 13212-4516
(315) 464-2000
(315) 464-2010

Taxonomy

Speciality
Code
Description
License number
State
2086S0127X
Trauma Surgery Physician
276597
NY
2086S0127X
Trauma Surgery Physician
Primary
50802
CT
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03914743
NY
Enumeration date
07/14/2010
Last updated
08/28/2019
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