Mia Ivancovich

NPI 1487467957 · on the registry since 2025 · sole proprietor

Practice

Address: 452 Suffolk Ave
Brentwood, NY 11717
Phone: (631) 436-6065
Organisation at this address: Town Of Islip
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 25

Registry record

Primary taxonomy: Registered Nurse
163W00000X
Also registered as: Addiction (Substance Use Disorder) Registered Nurse
Licence states on file: NY
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2025-01-29

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New York