National Provider Identifier
Nathaniel Mark Ivanick, MD
Nathaniel Mark Ivanick, MD is listed in the NPPES registry with a primary specialty of Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Buffalo, NY and a listed phone number of (716) 845-2300.
Profile Overview
- NPI
- 1063623098
- Provider Type
- Individual
- Primary Specialty
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Enumeration Date
- May 24, 2007
- Last Updated
- September 21, 2021
Practice Location
- Elm And Carlton Streets
- Buffalo, NY 14263-0001
Phone: (716) 845-2300
Specialties
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician (208G00000X)
- Pulmonary Disease Physician (207RP1001X)
Full Record
- NPI
- 1063623098
- Entity Type
- Individual
- Last Name
- Ivanick
- First Name
- Nathaniel
- Middle Name
- Mark
- Name Prefix
- Dr.
- Credential
- MD
- Mailing Street Address
- Elm And Carlton Streets
- Mailing City
- Buffalo
- Mailing State
- NY
- Mailing ZIP Code
- 14263-0001
- Mailing Country
- US
- Mailing Phone
- (716) 845-2300
- Practice Street Address
- Elm And Carlton Streets
- Practice City
- Buffalo
- Practice State
- NY
- Practice ZIP Code
- 14263-0001
- Practice Country
- US
- Practice Phone
- (716) 845-2300
- Enumeration Date
- May 24, 2007
- Last Updated
- September 21, 2021
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- September 21, 2021
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician (208G00000X), Pulmonary Disease Physician (207RP1001X)
- Other Identifiers
- 298396 (NY, Nys License), 05711793 (NY)