Healthcare Provider Details

I. General information

NPI: 1679189039
Provider Name (Legal Business Name): MEREDITH BREANN ZEMBIEC M.S. PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2020
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 BRENTWOOD DRIVE SUITE A
ITHACA NY
14850-1863
US

IV. Provider business mailing address

16 BRENTWOOD DR STE A
ITHACA NY
14850-1863
US

V. Phone/Fax

Practice location:
  • Phone: 607-272-7000
  • Fax:
Mailing address:
  • Phone: 607-272-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number027601
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: