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General NPI Number Information
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NPI Number | 1730596131
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Entity Type | Organization
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Legal Business Name | CAYUGA MEDICAL CENTER AT ITHACA
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Dates
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Enumeration Date | 07/17/2014
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 201 DATES DR STE 109
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City | ITHACA
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State | NY
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Zip | 14850-1345
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Country | US
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Telephone | 607-274-4385
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Fax |
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Provider Business Mailing Address
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Address Line | 201 DATES DR STE 109
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City | ITHACA
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State | NY
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Zip | 14850-1345
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO/SYSTEM PRESIDENT
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Name | MARTIN STALLONE
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Credential |
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Telephone | 607-274-4189
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 032823
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number | 032823
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License Number State | NY
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