Individual
DR. DONNA R. SANDIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
310 TAUGHANNOCK BLVD, SUITE 310, ITHACA, NY 14850-3251
(607) 252-3590
(607) 252-3592
Mailing address
310 TAUGHANNOCK BLVD, SUITE 310, ITHACA, NY 14850-3251
(607) 252-3590
(607) 252-3592
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
220140
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018306520001
—
PA
05
—
02154516
—
NY
01
—
030004925
RR MEDICARE PIN
NY
01
—
CC8362
RR MEDICARE GROUP
NY
Enumeration date
02/13/2006
Last updated
01/12/2016
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