Provider Demographics
NPI:1821554015
Name:CVIJANOVICH, MIETTE-JANINE (RNBC)
Entity Type:Individual
Prefix:
First Name:MIETTE-JANINE
Middle Name:
Last Name:CVIJANOVICH
Suffix:
Gender:F
Credentials:RNBC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 GRAYROCK PK RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3631
Mailing Address - Country:US
Mailing Address - Phone:914-843-0348
Mailing Address - Fax:
Practice Address - Street 1:6 GRAYROCK PK RD
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-3631
Practice Address - Country:US
Practice Address - Phone:914-843-0348
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-13
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4473961163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse