Nine Rivers Osteopathy Pc | |
200 Pleasant Grove Rd Ste 6 Ithaca NY 14850-2664 | |
(607) 257-0900 | |
(607) 257-0997 |
Full Name | Nine Rivers Osteopathy Pc |
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Speciality | Family Medicine |
Location | 200 Pleasant Grove Rd Ste 6, Ithaca, New York |
Authorized Official Name and Position | Michelle Teves (PRESIDENT) |
Authorized Official Contact | 5102200890 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Nine Rivers Osteopathy Pc 118 Park Ln Ithaca NY 14850-6352 Ph: (607) 257-0900 | Nine Rivers Osteopathy Pc 200 Pleasant Grove Rd Ste 6 Ithaca NY 14850-2664 Ph: (607) 257-0900 |
NPI Number | 1891104899 |
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Provider Enumeration Date | 08/05/2014 |
Last Update Date | 08/05/2014 |
Medicare PECOS PAC ID | 4284956459 |
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Medicare Enrollment ID | O20141126000440 |
Identifier | Type | State | Issuer |
---|---|---|---|
1891104899 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 271156 (New York) | Primary |
Provider Name | Michelle A Teves |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1881914067 PECOS PAC ID: 7214179415 Enrollment ID: I20130819000571 |
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