Provider Demographics
NPI:1285881110
Name:FALL CREEK HEALTH CARE
Entity type:Organization
Organization Name:FALL CREEK HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ZANTI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:607-277-5449
Mailing Address - Street 1:423 1ST ST
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-3503
Mailing Address - Country:US
Mailing Address - Phone:607-277-5449
Mailing Address - Fax:607-277-5606
Practice Address - Street 1:423 1ST ST
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-3503
Practice Address - Country:US
Practice Address - Phone:607-277-5449
Practice Address - Fax:607-277-5606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-21
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008273-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU63184Medicare UPIN