Trumansburg Family Health Center | |
4435 Seneca Rd Trumansburg NY 14886-9201 | |
(607) 387-5707 | |
(607) 387-4354 |
Full Name | Trumansburg Family Health Center |
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Speciality | Family Medicine |
Location | 4435 Seneca Rd, Trumansburg, New York |
Authorized Official Name and Position | John D. Cooke (MEMBER/OWNER) |
Authorized Official Contact | 6073875707 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Trumansburg Family Health Center 4435 Seneca Rd Trumansburg NY 14886-9201 Ph: (607) 387-5707 | Trumansburg Family Health Center 4435 Seneca Rd Trumansburg NY 14886-9201 Ph: (607) 387-5707 |
NPI Number | 1528056942 |
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Provider Enumeration Date | 10/10/2005 |
Last Update Date | 02/06/2014 |
Medicare PECOS PAC ID | 5395846794 |
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Medicare Enrollment ID | O20070730000594 |
Identifier | Type | State | Issuer |
---|---|---|---|
1528056942 | NPI | - | NPPES |
02863638 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Shawnti R Storm |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1861411613 PECOS PAC ID: 6406881820 Enrollment ID: I20051004000702 |
Provider Name | Michelle P Blegen |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1053309484 PECOS PAC ID: 5193826592 Enrollment ID: I20070730000666 |
Provider Name | John D Cooke |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1427046853 PECOS PAC ID: 7911008313 Enrollment ID: I20070730000686 |
Provider Name | Maura C Mccauley |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1023059334 PECOS PAC ID: 3678631645 Enrollment ID: I20081020000354 |
Provider Name | Gerrit William Heetderks |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1740546746 PECOS PAC ID: 5193038784 Enrollment ID: I20150727000710 |
Provider Name | Kevin Hastings |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1609257468 PECOS PAC ID: 1951616861 Enrollment ID: I20150820010693 |
Provider Name | Johannah Elizabeth Shortle |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1336664655 PECOS PAC ID: 8224301965 Enrollment ID: I20170831002264 |
Provider Name | Cynthia Davis |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1164918546 PECOS PAC ID: 1951659184 Enrollment ID: I20180806000173 |
Provider Name | Kelly Seaman |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1679840722 PECOS PAC ID: 4385974229 Enrollment ID: I20190919001624 |
Provider Name | Jeannine Marie Destries |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1114543691 PECOS PAC ID: 6800212051 Enrollment ID: I20200818002767 |
Provider Name | Karren Vlahos |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1083104202 PECOS PAC ID: 7517213044 Enrollment ID: I20220829002411 |
Trumansburg Family Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4435 E Seneca Rd, Trumansburg, NY 14886 Phone: 607-387-5707 Fax: 607-387-4354 |