| 24 On Physician New York, Pc | |
|
101 Dates Dr Ithaca NY 14850-1342 | |
| (607) 274-4191 | |
| (607) 274-4198 |
| Full Name | 24 On Physician New York, Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 101 Dates Dr, Ithaca, New York |
| Authorized Official Name and Position | Dan Fuller (PRESIDENT) |
| Authorized Official Contact | 7707400895 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 24 On Physician New York, Pc Po Box 403631 Atlanta GA 30384-3631 Ph: (770) 740-0895 | 24 On Physician New York, Pc 101 Dates Dr Ithaca NY 14850-1342 Ph: (607) 274-4191 |
| NPI Number | 1285799163 |
|---|---|
| Provider Enumeration Date | 12/22/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285799163 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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