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General NPI Number Information
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NPI Number | 1174383681
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Entity Type | Organization
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Legal Business Name | TOMPKINS TMS, LLC
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Dates
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Enumeration Date | 03/21/2024
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Last Update Date | 03/21/2024
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Provider Practice Location Address
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Address Line | 103 W SENECA ST STE 302
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City | ITHACA
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State | NY
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Zip | 14850-4157
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Country | US
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Telephone | 607-216-0532
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Fax | 607-339-0062
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Provider Business Mailing Address
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Address Line | 63 HICKORY CIR
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City | ITHACA
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State | NY
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Zip | 14850-9610
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Country | US
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Telephone | 607-379-9429
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Fax | 607-339-0062
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN-PAUL DANIEL MEAD
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Credential | MD
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Telephone | 607-216-0532
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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