Healthcare Provider Details

I. General information

NPI: 1477877876
Provider Name (Legal Business Name): CAYUGA MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2010
Last Update Date: 03/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 TAUGHANNOCK BLVD
ITHACA NY
14850-3251
US

IV. Provider business mailing address

310 TAUGHANNOCK BLVD
ITHACA NY
14850-3251
US

V. Phone/Fax

Practice location:
  • Phone: 607-252-3500
  • Fax: 607-252-3505
Mailing address:
  • Phone: 607-252-3500
  • Fax: 607-252-3505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NR1301X
TaxonomyRural Acute Care Hospital
License Number1962422733
License Number StateNY

VIII. Authorized Official

Name: MRS. CHRISTINE MARIE FEELY
Title or Position: PHYSICAL THERAPIST
Credential: MPT
Phone: 607-252-3500