DR. MARK J IVANICK MD NPI 1629065198

NPI Information

NPI: 1629065198
Provider Name: DR. MARK J IVANICK, MD
Classification: Internal Medicine - 207RP1001X
Entity Type: Individual

Specialization: Pulmonary Disease

Address:
600 ROE AVENUE
SUITE 4A
ELMIRA, NY
ZIP 14905
Phone: (607) 271-3780
Get Directions

DR. Mark J Ivanick, MD is a pulmonary disease internal medicine in Elmira, NY. The provider is an internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. DR. Mark J Ivanick, MD NPI is 1629065198. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

600 ROE AVENUE
SUITE 4A
ELMIRA, NY
ZIP 14905-629
Phone: (607) 271-3780
Fax: (607) 271-3894

The enumeration date for this NPI number is 9/30/2005 and was last updated on 11/25/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RC0200X	Internal Medicine	Critical Care Medicine	139254	NEW YORK	No
2	207RP1001X	Internal Medicine	Pulmonary Disease	NY139254-1	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	001003160	MEDICAID	PENNSYLVANIA
2	00650211	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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