| Primary Care Internal Medicine Of Ithaca, Pllc | |
|
217 N Aurora St Ithaca NY 14850-4345 | |
| (607) 273-2811 | |
| (607) 273-1170 |
| Full Name | Primary Care Internal Medicine Of Ithaca, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 217 N Aurora St, Ithaca, New York |
| Authorized Official Name and Position | Ann R Costello (OWNER) |
| Authorized Official Contact | 6072732811 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary Care Internal Medicine Of Ithaca, Pllc 217 N Aurora St Ithaca NY 14850-4345 Ph: (607) 273-2811 | Primary Care Internal Medicine Of Ithaca, Pllc 217 N Aurora St Ithaca NY 14850-4345 Ph: (607) 273-2811 |
| NPI Number | 1043736309 |
|---|---|
| Provider Enumeration Date | 08/18/2017 |
| Last Update Date | 08/18/2017 |
| Medicare PECOS PAC ID | 0244504405 |
|---|---|
| Medicare Enrollment ID | O20170927000576 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043736309 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Lucia Jander |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851368732 PECOS PAC ID: 3577564798 Enrollment ID: I20070130000571 |
| Provider Name | Ann R Costello |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235125626 PECOS PAC ID: 6507903606 Enrollment ID: I20091022000103 |
| Provider Name | Stephanie Gumaer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629378062 PECOS PAC ID: 2769727056 Enrollment ID: I20181213003140 |
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