Ivanick, Nathaniel Mark
Ivanick, Nathaniel Mark is an individual health care provider with primary practice located at Elm And Carlton Streets , Buffalo NY 14263-0001. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pulmonary Disease, Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery). Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) is his primary health care specialty. Ivanick, Nathaniel Mark can be contacted via phone (716) 845-2300.Contact Information
Primary practice address
Elm And Carlton Streets
Buffalo NY 14263-0001
Phone: (716) 845-2300
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | C154270 | California |
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | 298396 | New York |
| Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) | 208G00000X | 298396 | New York |
Profile Details
| NPI number | 1063623098 |
|---|---|
| LBN Legal business name | Ivanick, Nathaniel Mark |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 24th, 2007 |
| Last updated | Sep 21st, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063623098 | NPPES |
| New York | Other | 298396 | NYS LICENSE |
| New York | MEDICAID | 05711793 | NYS LICENSE |
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