Healthcare Provider Details

I. General information

NPI: 1619010014
Provider Name (Legal Business Name): TTPM, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 05/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 W CHURCH ST
ELMIRA NY
14905-2526
US

IV. Provider business mailing address

530 W CHURCH ST
ELMIRA NY
14905-2526
US

V. Phone/Fax

Practice location:
  • Phone: 607-733-6094
  • Fax: 607-732-1812
Mailing address:
  • Phone: 607-733-6094
  • Fax: 607-732-1812

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247000000X
TaxonomyHealth Information Technician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
IdentifierCI0915
Identifier TypeOTHER
Identifier StateNY
Identifier IssuerPALMETTO GBA
# 2
Identifier470000999
Identifier TypeOTHER
Identifier StateNY
Identifier IssuerPALMETTO GBA
# 3
Identifier01072673
Identifier TypeMEDICAID
Identifier StateNY
Identifier Issuer

VIII. Authorized Official

Name: MISS DEBORAH L OSTRANDE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 607-733-6094