24 On Physician New York, PC

NPI #1285799163 in Ithaca, New York

Provider Information

NPI Number: 1285799163
Entity Type: Organization
Organization Name: 24 On Physician New York, PC
Primary Specialty: Internal Medicine
Enumeration Date: Dec 22, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 101 DATES DR
City: Ithaca
State: New York
ZIP Code: 14850-1342
Phone: (607) 274-4191

Authorized Official

Name: DAN FULLER
Title: PRESIDENT
Phone: (770) 740-0895

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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