| Trumansburg Medicine Pllc | |
|
4435 Seneca Rd Trumansburg NY 14886-9201 | |
| (607) 387-5707 | |
| (607) 387-4354 |
| Full Name | Trumansburg Medicine Pllc |
|---|---|
| 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 |
|---|---|
| Trumansburg Medicine Pllc 4435 Seneca Rd Trumansburg NY 14886-9201 Ph: (607) 387-5707 | Trumansburg Medicine Pllc 4435 Seneca Rd Trumansburg NY 14886-9201 Ph: (607) 387-5707 |
| NPI Number | 1528056942 |
|---|---|
| Provider Enumeration Date | 10/10/2005 |
| Last Update Date | 02/06/2014 |
| Medicare PECOS PAC ID | 5395846794 |
|---|---|
| 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 |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861411613 PECOS PAC ID: 6406881820 Enrollment ID: I20051004000702 |
| Provider Name | Michelle P Blegen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053309484 PECOS PAC ID: 5193826592 Enrollment ID: I20070730000666 |
| Provider Name | John D Cooke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427046853 PECOS PAC ID: 7911008313 Enrollment ID: I20070730000686 |
| Provider Name | Maura C Mccauley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023059334 PECOS PAC ID: 3678631645 Enrollment ID: I20081020000354 |
| Provider Name | Gerrit William Heetderks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740546746 PECOS PAC ID: 5193038784 Enrollment ID: I20150727000710 |
| Provider Name | Kevin Hastings |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609257468 PECOS PAC ID: 1951616861 Enrollment ID: I20150820010693 |
| Provider Name | Johannah Elizabeth Shortle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336664655 PECOS PAC ID: 8224301965 Enrollment ID: I20170831002264 |
| Provider Name | Cynthia Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164918546 PECOS PAC ID: 1951659184 Enrollment ID: I20180806000173 |
| Provider Name | Kelly Seaman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679840722 PECOS PAC ID: 4385974229 Enrollment ID: I20190919001624 |
| Provider Name | Jeannine Marie Destries |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114543691 PECOS PAC ID: 6800212051 Enrollment ID: I20200818002767 |
| Provider Name | Karren C Downs |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083104202 PECOS PAC ID: 7517213044 Enrollment ID: I20220829002411 |
Medical Office Of Lessinger, Soboroff And Anderson, Pllc 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 |