Provider Demographics
NPI:1548237043
Name:IVANY, GLORIA A (NP)
Entity Type:Individual
Prefix:MISS
First Name:GLORIA
Middle Name:A
Last Name:IVANY
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Gender:F
Credentials:NP
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Mailing Address - Street 1:79 MIDDLEVILLE RD
Mailing Address - Street 2:HEM/ONC DEPART BLDG 200
Mailing Address - City:NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11768-2200
Mailing Address - Country:US
Mailing Address - Phone:631-261-4400
Mailing Address - Fax:631-266-6005
Practice Address - Street 1:79 MIDDLEVILLE RD
Practice Address - Street 2:HEM/ONC DEPART BLDG 200
Practice Address - City:NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11768-2200
Practice Address - Country:US
Practice Address - Phone:631-261-4400
Practice Address - Fax:631-266-6005
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-02
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NY301055-1363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner