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MIA IVANCOVICH
NPI 1487467957
Registered Nurse in Brentwood, NY

Active since January 29, 2025
452 SUFFOLK AVE, BRENTWOOD, NY 11717(631) 436-6065 Get Directions Write a Review

NPPES record last updated: January 29, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mia Ivancovich NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MIA IVANCOVICH (NPI 1487467957) is an individual registered nurse in Brentwood, New York, licensed in New York (813227-01) and active in the NPI registry since January 2025.

NPPES Registry Identity

NPI1487467957
Entity TypeIndividualFemale
Primary Taxonomy163W00000X
Provider Legal NameMIA IVANCOVICH
Location Address452 SUFFOLK AVEBrentwood, NY 11717-4214
Mailing Address67 Millay LnBay Shore, NY 11706-4329
Phone(631) 436-6065
Sole ProprietorYes
Enumeration DateJanuary 29, 2025
NPPES CertifiedJanuary 29, 2025
✔ NPI 1487467957 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyRegistered NurseNursing Service Providers
Taxonomy Code163W00000X
License✔ Licensed in NY · 813227-01
Definition
(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 in recovering and maintaining their physical or mental health. They assist physicians during treatments and examinations and administer medications. (2) A provider who is trained and educated in a formal nursing education program at an accredited school of nursing, passes a national certification examination, and is licensed by the state to practice nursing. The individual provides nursing services to patients or clients in areas such as health promotion, disease prevention, acute and chronic care and restoration and maintenance of health across the life span.
Also ListedRegistered Nurse · Addiction (Substance Use Disorder)Taxonomy 163WA0400X · License 813227-01 (NY)
452 SUFFOLK AVE, Brentwood, NY 11717
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CARMEN BETANCOURT-NEDWICK LCSW
Counselor
452 SUFFOLK AVE
BRENTWOOD, NY 11717
Suffolk County (631) 436-6065
TOWN OF ISLIP
Counselor (Addiction (Substance Use Disorder))
452 SUFFOLK AVE
BRENTWOOD, NY 11717
Suffolk County (631) 436-6065
EMILIA SOUZA
Counselor (Addiction (Substance Use Disorder))
452 SUFFOLK AVE
BRENTWOOD, NY 11717
Suffolk County (631) 436-6065
MRS. SONDRA RAYNETTE HUGGINS
Student in an Organized Health Care Education/Training Program
452 SUFFOLK AVE
BRENTWOOD, NY 11717
Suffolk County (631) 436-6065
EMILY FASOLINO CASAC-T
Counselor (Addiction (Substance Use Disorder))
452 SUFFOLK AVE
BRENTWOOD, NY 11717
Suffolk County (631) 436-6065
JOSEPH MICHAEL MARTINO LMSW, CASAC
Counselor (Addiction (Substance Use Disorder))
452 SUFFOLK AVE
BRENTWOOD, NY 11717
Suffolk County (631) 436-6065
KENIA E DE LA ROSA LMSW
Counselor (Addiction (Substance Use Disorder))
452 SUFFOLK AVE
BRENTWOOD, NY 11717
Suffolk County (631) 436-6065
JOHNNY MORALES LMSW
Social Worker
452 SUFFOLK AVE
BRENTWOOD, NY 11717
Suffolk County (631) 436-6065

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mia Ivancovich's NPI number?

The NPI number for Mia Ivancovich is 1487467957. It was assigned to this individual provider in the NPPES registry on January 29, 2025.

Where is Mia Ivancovich located?

Mia Ivancovich practices at 452 Suffolk Ave, Brentwood, NY 11717. The listed phone number is (631) 436-6065.

What is Mia Ivancovich's specialty?

The primary specialty registered for this NPI is Registered Nurse with taxonomy code 163W00000X.

When was this NPI record last updated?

The NPPES record for Mia Ivancovich was last updated on January 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.