# CAYUGA MEDICAL CENTER EMPLOYED PHYSICIANS GROUP

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CAYUGA MEDICAL CENTER
- **Other names:** Cayuga Medical Center
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1730596107
- **Legal business name:** CAYUGA MEDICAL CENTER
- **Authorized official:** JOHN COLLETT (CFO)
- **Authorized official phone:** (607) 274-4441

## Contact information

- **Practice address:** 101 DATES DR, ITHACA, NY 14850-1342
- **Practice address phone:** (607) 274-4441
- **Mailing address:** 101 DATES DR, ITHACA, NY 14850-1342
- **Mailing address phone:** (607) 274-4441

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TC0700X | Clinical Psychologist | — | NULL | — |
| 103TC0700X | Clinical Psychologist | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | — | NULL | — |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207RH0003X | Hematology & Oncology Physician | — | NULL | — |
| 207RH0003X | Hematology & Oncology Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 2080N0001X | Neonatal-Perinatal Medicine Physician | — | NULL | Yes |
| 2080N0001X | Neonatal-Perinatal Medicine Physician | — | — | Yes |
| 2084P0800X | Psychiatry Physician | — | NULL | — |
| 2084P0800X | Psychiatry Physician | — | — | — |

## Other

- **Enumeration date:** 07/17/2014
- **Last updated:** 07/18/2014