| Cayuga Neurologic Services Llp | |
|
119 W Buffalo St Ithaca NY 14850-4131 | |
| (607) 273-6757 | |
| (607) 273-2854 |
| Full Name | Cayuga Neurologic Services Llp |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 119 W Buffalo St, Ithaca, New York |
| Authorized Official Name and Position | Jody M Stackman (SENIOR PARTNER) |
| Authorized Official Contact | 6072736757 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cayuga Neurologic Services Llp 119 W Buffalo St Ithaca NY 14850-4131 Ph: (607) 273-6757 | Cayuga Neurologic Services Llp 119 W Buffalo St Ithaca NY 14850-4131 Ph: (607) 273-6757 |
| NPI Number | 1578636379 |
|---|---|
| Provider Enumeration Date | 11/17/2006 |
| Last Update Date | 10/12/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578636379 | NPI | - | NPPES |
| 01335900 | Medicaid | NY | |
| 02068793 | Medicaid | NY | |
| 00711413 | Medicaid | NY | |
| 02883223 | Medicaid | NY | |
| 03191393 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 132611 (New York) | Primary |
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