Progressive Medicine Of Ithaca, Pc | |
402 3rd Street Suite 2 Ithaca NY 14850 | |
(607) 272-9938 | |
(607) 272-9996 |
Full Name | Progressive Medicine Of Ithaca, Pc |
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Speciality | Family Medicine |
Location | 402 3rd Street, Ithaca, New York |
Authorized Official Name and Position | John W Weston (OWNER) |
Authorized Official Contact | 6072729938 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Progressive Medicine Of Ithaca, Pc 402 3rd Street Suite 2 Ithaca NY 14850 Ph: (607) 272-9938 | Progressive Medicine Of Ithaca, Pc 402 3rd Street Suite 2 Ithaca NY 14850 Ph: (607) 272-9938 |
NPI Number | 1467621797 |
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Provider Enumeration Date | 02/20/2008 |
Last Update Date | 05/01/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1467621797 | NPI | - | NPPES |
02383448 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 224502 (New York) | Primary |
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