Pavkovic, Ivan Mark

Pavkovic, Ivan Mark is an individual health care provider with primary practice located at 410 Lakeville Rd Suite 105, New Hyde Park NY 11042-1101. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Neurodevelopmental Disabilities. Allopathic & Osteopathic Physicians / Neurodevelopmental Disabilities is his primary health care specialty. Pavkovic, Ivan Mark can be contacted via phone (516) 465-5255.

Contact Information

Primary practice address
410 Lakeville Rd Suite 105 New Hyde Park NY 11042-1101
Phone: (516) 465-5255
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 19840 Nebraska
Allopathic & Osteopathic Physicians / Neurodevelopmental Disabilities 2080P0008X 2008-01446 North Carolina
Allopathic & Osteopathic Physicians / Neurodevelopmental Disabilities 2080P0008X 282145 New York

Profile Details

NPI number 1528060068
LBN Legal business name Pavkovic, Ivan Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 15th, 2005
Last updated Apr 5th, 2016 - about 8 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528060068 NPPES
Nebraska Other 04056 BLUE CROSS BLUE SHIELD NE

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