Organization
CAYUGA NEUROLOGIC SERVICES LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JODY M STACKMAN MD (SENIOR PARTNER)
(607) 273-6757
Entity
Organization
Contact information
Practice address
119 W BUFFALO ST, ITHACA, NY 14850-4131
(607) 273-6757
(607) 273-2854
Mailing address
119 W BUFFALO ST, ITHACA, NY 14850-4131
(607) 273-6757
(607) 273-2854
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
132611
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00711413
—
NY
05
—
01335900
—
NY
05
—
02068793
—
NY
05
—
02883223
—
NY
05
—
03191393
—
NY
Enumeration date
11/17/2006
Last updated
10/12/2010
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