Healthcare Provider Details

I. General information

NPI: 1023166691
Provider Name (Legal Business Name): TOMPKINS COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 01/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 BROWN RD
ITHACA NY
14850-1247
US

IV. Provider business mailing address

55 BROWN RD
ITHACA NY
14850-1247
US

V. Phone/Fax

Practice location:
  • Phone: 607-274-6604
  • Fax: 607-274-6620
Mailing address:
  • Phone: 607-274-6604
  • Fax: 607-274-6620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. BRENDA L GRINNELL-CROSBY
Title or Position: PUBLIC HEALTH ADMINISTRATOR
Credential:
Phone: 607-274-6677