Organization
ITHACA PODIATRY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY KADLECIK X (OWNER)
(607) 257-7700
Entity
Organization
Contact information
Practice address
2333 N TRIPHAMMER RD, SUITE 202, ITHACA, NY 14850-1082
(607) 257-7700
Mailing address
2333 N TRIPHAMMER RD, SUITE 202, ITHACA, NY 14850-1082
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
N005805
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02195908
—
NY
Enumeration date
03/17/2008
Last updated
06/18/2008
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