Family Medicine Associates of Ithaca

NPI #1013324318 in Ithaca, New York

Provider Information

NPI Number
1013324318
Entity Type
Organization
Organization Name
Family Medicine Associates of Ithaca
Subpart
Yes (part of a larger organization)
Parent Organization
MEDVANTX, INC.
Primary Specialty
Non-Pharmacy Dispensing Site
Enumeration Date
Jul 18, 2014
Last Updated
Jul 21, 2014

Practice Location

Address
209 W STATE ST
City
Ithaca
ZIP Code
14850-5429
Phone
(607) 277-4341

Authorized Official

Name
KENNY HEINE
Title
VP OF OPERATIONS
Phone
(858) 964-1506

Specialties & Taxonomy Codes

Specialty
Non-Pharmacy Dispensing Site

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