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NPI Code Detail

MEDICARE: SIMPLIFED IPA LLC

MEDICARE: SIMPLIFED IPA LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174N00000XLactation Consultant (Non-RN)

General Provider Information

NPI Number : 1952009615
Entity Type Code : Organization
Provider Name (Legal Business Name) : SIMPLIFED IPA LLC
Provider Business Mailing Address
First Line : 314 E STATE ST
Second Line :
City : ITHACA
State : NY
Zip : 14850-4318
Country : US
Telephone Number : 844-799-0538
Fax Number : 631-201-7097
Provider Business Practice Location Address
First Line : 314 E STATE ST
Second Line :
City : ITHACA
State : NY
Zip : 14850-4318
Country : US
Telephone Number : 844-799-0538
Fax Number : 631-201-7097
Authorized Official
Title or Position : CEO
Name : ANDREA IPPOLITO
Credential :
Telephone Number : 339-234-0164
Provider Enumeration Date : 02/21/2023
Last Update Date : 02/21/2023

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Directions to “SIMPLIFED IPA LLC ” Practice Location

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