National Provider Identifier
Mark J Ivanick, MD
Mark J Ivanick, MD is listed in the NPPES registry with a primary specialty of Pulmonary Disease Physician in Elmira, NY and a listed phone number of (607) 271-3780.
Profile Overview
- NPI
- 1629065198
- Provider Type
- Individual
- Primary Specialty
- Pulmonary Disease Physician
- Enumeration Date
- September 30, 2005
- Last Updated
- November 25, 2020
Practice Location
- 600 Roe Avenue
- Suite 4A
- Elmira, NY 14905-1629
Phone: (607) 271-3780
Mailing Address
- 571 Saint Josephs Blvd Fl 2
- Elmira, NY 14901-3230
Specialties
- Pulmonary Disease Physician (207RP1001X)
- Critical Care Medicine (Internal Medicine) Physician (207RC0200X)
Full Record
- NPI
- 1629065198
- Entity Type
- Individual
- Last Name
- Ivanick
- First Name
- Mark
- Middle Name
- J
- Name Prefix
- Dr.
- Credential
- MD
- Mailing Street Address
- 571 Saint Josephs Blvd Fl 2
- Mailing City
- Elmira
- Mailing State
- NY
- Mailing ZIP Code
- 14901-3230
- Mailing Country
- US
- Mailing Phone
- (607) 271-2050
- Mailing Fax
- (607) 873-1244
- Practice Street Address
- 600 Roe Avenue
- Practice Address Line 2
- Suite 4A
- Practice City
- Elmira
- Practice State
- NY
- Practice ZIP Code
- 14905-1629
- Practice Country
- US
- Practice Phone
- (607) 271-3780
- Practice Fax
- (607) 271-3894
- Enumeration Date
- September 30, 2005
- Last Updated
- November 25, 2020
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- November 25, 2020
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Pulmonary Disease Physician (207RP1001X), Critical Care Medicine (Internal Medicine) Physician (207RC0200X)
- Other Identifiers
- 001003160 (PA), 00650211 (NY)