| NAME |
TOMPKINS COUNTY VA CLINIC |
| STATE |
NEW YORK |
| STREET ADDR. 1 |
2309 N TRIPHAMMER RD |
| CITY |
ITHACA |
| ZIP |
14850-1060 |
| OFFICIAL VA NAME |
TOMPKINS COUNTY VA CLINIC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
ITHACA VA CLINIC |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1164474177
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
528G9 |
| HISTORY |
-
- STREET ADDR. 1 (CHANGED FROM): 1451 DRYDEN ROAD
- CITY (CHANGED FROM): FREEVILLE
- STATE (CHANGED FROM): NEW YORK
- ZIP (CHANGED FROM): 13068-9633
|
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1164474177
-
- CODING SYSTEM: VASTANUM
- ID: 528G9
-
- CODING SYSTEM: CLIA
- ID: 33D2020252
|
