Provider Demographics
NPI:1154003689
Name:SIMPLIFED MEDICAL, P.C.
Entity type:Organization
Organization Name:SIMPLIFED MEDICAL, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:IPPOLITO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:339-234-0164
Mailing Address - Street 1:314 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-4318
Mailing Address - Country:US
Mailing Address - Phone:888-458-1364
Mailing Address - Fax:
Practice Address - Street 1:314 E STATE ST
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-4318
Practice Address - Country:US
Practice Address - Phone:888-458-1364
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Multi-Specialty
No163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Multi-Specialty