Individual provider · Type 1 NPI

Mia Ivancovich

Registered Nurse · Brentwood, NY

NPI number 1487467957 Active

Practice location

452 Suffolk Ave
Brentwood, NY 11717-4214

Mailing address

67 Millay Ln
Bay Shore, NY 11706-4329

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X813227-01 (NY)
Registered Nurse Primary 163W00000X813227-01 (NY)

Registered Nurse: (1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.'s assist patient…

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About NPI 1487467957

Mia Ivancovich's National Provider Identifier is 1487467957, issued on Jan 29, 2025. The primary taxonomy on file is Registered Nurse (163W00000X), and the practice location is in Brentwood, NY. The record was last updated on Jan 29, 2025.