Organization
ITHACA HEALTH ALLIANCE
Active
Other names
Ithaca Free Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NORBERT G MCCLOSKEY EXECUTIVE DIRECTOR (EXECUTIVE DIRECTOR)
(607) 882-9060
Entity
Organization
Contact information
Practice address
521 W SENECA ST, ITHACA, NY 14850-4033
(607) 330-1254
(607) 330-1194
Mailing address
521 W SENECA ST, ITHACA, NY 14850-4033
(607) 330-1254
(607) 330-1194
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
04/09/2019
Last updated
04/09/2019
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