| Cayuga Medical Center At Ithaca | |
|
101 Dates Dr Ithaca NY 14850-1342 | |
| (607) 274-4443 | |
| (607) 274-4527 |
| Full Name | Cayuga Medical Center At Ithaca |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 101 Dates Dr, Ithaca, New York |
| Authorized Official Name and Position | John Rudd (SENIOR VP CFO) |
| Authorized Official Contact | 6072744443 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cayuga Medical Center At Ithaca 101 Dates Dr Ithaca NY 14850-1342 Ph: (607) 274-4443 | Cayuga Medical Center At Ithaca 101 Dates Dr Ithaca NY 14850-1342 Ph: (607) 274-4443 |
| NPI Number | 1144397100 |
|---|---|
| Provider Enumeration Date | 11/28/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144397100 | NPI | - | NPPES |
| 33S307 | Other | NY | BLUE CROSS - PSYCH |
| 5401001H | Other | NY | NYS PROVIDER OPER CERT # |
| 365593 | Other | NY | MVP PROVIDER NO |
| 00332729 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 7247020 (New York) | Secondary |
| 273R00000X | Psychiatric Unit | 7247021 (New York) | Primary |
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