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Contact Information

PROGRESSIVE MEDICINE OF ITHACA, PC
402 3RD STREET
SUITE 2
ITHACA, NY14850
 Phone: 607-272-9938
 Fax: 607-272-9996
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for PROGRESSIVE MEDICINE OF ITHACA, PC

NPI Number 1467621797
LBN Legal business name PROGRESSIVE MEDICINE OF ITHACA, PC
Authorized official JOHN WESTON - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 02/20/2008
Last updated 05/01/2008 - About 11 years ago
Identifiers
NY License # 224502
NY Medicaid 02383448
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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