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NPI Code Detail

MEDICARE: REBECCA IVICIC PSYD

MEDICARE: REBECCA IVICIC PSYD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist022424NY

General Provider Information

NPI Number : 1528917440
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA IVICIC PSYD
Provider Business Mailing Address
First Line : 220 ROUTE 6
Second Line :
City : MAHOPAC
State : NY
Zip : 10541-3850
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 220 ROUTE 6
Second Line :
City : MAHOPAC
State : NY
Zip : 10541-3850
Country : US
Telephone Number : 914-246-8884
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2026
Last Update Date : 01/23/2026

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Directions to “ REBECCA IVICIC PSYD” Practice Location

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