DR. NATHANIEL MARK IVANICK (NPI# 1063623098) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063623098 |
| Entity Type | Individual |
| Full Name | DR. NATHANIEL MARK IVANICK |
| Credential | MD |
| Practice Address |
Elm and Carlton Streets Buffalo NY 14263-0001 |
| Practice Telephone | 7168452300 |
| Mailing Telephone | 7168452300 |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2020-02-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
298396 | NY | Allopathic & Osteopathic Physicians |
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
C154270 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | NYS LICENSE | 298396 | 01 |
| NY | 05711793 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 701 E El Camino Real, Mountain View, CA 940402833 | 6504047144 |
| Street Address |
ELM AND CARLTON STREETS |
| City | BUFFALO |
| State | NY |
| Zip Code | 14263-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588667083 | Ahmed Nabil Belal | Radiology | Elm and Carlton Streets, Buffalo, NY 14263-0001 | 2005-05-27 |
| 1215537204 | Carolyn Robinson | Nurse Practitioner | Elm and Carlton Streets, Buffalo, NY 14263-0001 | 2020-10-28 |
| 1578186862 | Alexandra Dione Huffman | Nurse Practitioner | Elm and Carlton Streets, Buffalo, NY 14263-0001 | 2020-05-21 |
| 1013538461 | Gordon Bolles | Nurse Practitioner | Elm and Carlton Streets, Buffalo, NY 14263-0001 | 2020-04-27 |
| 1396371746 | Tiffany Marie Meyers | Nurse Practitioner | Elm and Carlton Streets, Buffalo, NY 14263-0001 | 2020-03-18 |
| 1275172934 | Chereve Ferry | Nurse Practitioner | Elm and Carlton Streets, Buffalo, NY 14263-0001 | 2019-12-30 |
| 1255972386 | Rosh-neke Dezarae Thomas | Nurse Practitioner | Elm and Carlton Streets, Buffalo, NY 14263-0001 | 2019-09-30 |
| 1205486271 | Kimberly Lynn Murray | Nurse Practitioner | Elm and Carlton Streets, Buffalo, NY 14267-0002 | 2019-09-12 |
| 1629626098 | Danielle Wegrzyn | Physician Assistant | Elm and Carlton Streets, Buffalo, NY 14263-0001 | 2019-08-29 |
| 1588210827 | Katherine Mahar | Physician Assistant | Elm and Carlton Streets, Buffalo, NY 14263-0001 | 2019-08-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093321168 | Fernando Andres Angarita Celis | Surgery | Rosuell Park Comprehensive Cancer Center / Elm & Carlto, Streets / Scott Bieler Clinical Services Center 6th Fl, Buffalo, NY 14263 | 2020-09-23 |
| 1972074797 | Roswell Park Pharmacy Corporation | Pharmacy | Elm & Carlton Sts., Buffalo, NY 14263 | 2018-12-06 |
| 1235617861 | Heather Marie Poushay | Student in an Organized Health Care Education/Training Program | 665 Elm Street Roswell Park Comprehensive Cancer Canter, Attn Michelle Rotella, Buffalo, NY 14263 | 2018-08-06 |
| 1205212594 | Neelam Sandhu | Student in an Organized Health Care Education/Training Program | Elm & Carlton Streets Oncological Surgical Pathology, Roswell Park Cancer Institute, Buffalo, NY 14263 | 2015-08-10 |
| 1629413265 | Ivan Walter Cohen | Anesthesiology | Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY 14263 | 2013-05-09 |
| 1811243041 | Priyanka Maridhi Nanjireddy | Pediatrics | Roswell Park/oishei Children's Cancer and Blood Disorde, 685 Elm Street, Buffalo, NY 14263 | 2012-07-25 |
| 1760552699 | Mohamed Mokhtar El Sayed Desouki | Pathology | Elm & Carlton Streets, Buffalo, NY 14263 | 2006-11-08 |
| 1851948194 | Jamie Kerner | Nurse Practitioner | Elm & Carlton Streets, Buffalo, NY 14263 | 2019-08-21 |
| 1851856967 | Emily Taylor Haas | Nurse Practitioner | Elm & Carlton Streets, Buffalo, NY 14263 | 2019-02-02 |
| 1083134928 | Megan Elizabeth Schaefer | Physician Assistant | Elm and Carlton St, Buffalo, NY 14263 | 2017-06-21 |
| Find all providers in zip 14263 | ||||
| Taxonomy Code | 207RP1001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Pulmonary Disease |
| An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144268103 | Ravi K Desai, Md, PC | Internal Medicine | 33 Middlesex Rd, Buffalo, NY 14216-3615 | 2006-06-03 |
| 1396701843 | Iqbal Abdus Samad | Internal Medicine | 2148 Main St, Buffalo, NY 14214-2668 | 2006-04-25 |
| 1093913519 | Carla Anne Frederick | Internal Medicine | 100 High St, B8, Buffalo, NY 14203-1126 | 2007-07-05 |
| 1295869816 | Bruce L Platt M.d.,p.c. | Internal Medicine | 1616 Kensington Ave, Buffalo, NY 14215-1433 | 2007-03-15 |
| 1265579536 | Anthony J Buscaglia | Internal Medicine | 515 Abbott Rd, Suite 102, Buffalo, NY 14220-1700 | 2007-01-30 |
| 1124129820 | Eric Tenbrock | Internal Medicine | 100 High St, Buffalo, NY 14203-1126 | 2006-09-26 |
| 1538269857 | Jamson Lwebuga-mukasa | Internal Medicine | 100 High St, Buffalo, NY 14203-1126 | 2006-09-25 |
| 1295838233 | M Jeffery Mador | Internal Medicine | 3495 Bailey Ave, Buffalo, NY 14215-1129 | 2006-09-06 |
| 1215042700 | William Gibbons | Internal Medicine | 100 High St, Buffalo, NY 14203-1126 | 2006-08-21 |
| 1972567741 | Norman J Sfeir | Internal Medicine | 1616 Kensington Ave, Buffalo, NY 14215-1433 | 2006-04-17 |
| Find all providers in BUFFALO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.