Provider Demographics
NPI:1306995642
Name:TOMPKINS COUNTY
Entity type:Organization
Organization Name:TOMPKINS COUNTY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PUBLIC HEALTH ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:GRINNELL-CROSBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-274-6677
Mailing Address - Street 1:55 BROWN RD
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-1247
Mailing Address - Country:US
Mailing Address - Phone:607-274-6616
Mailing Address - Fax:607-274-6620
Practice Address - Street 1:55 BROWN RD
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-1247
Practice Address - Country:US
Practice Address - Phone:607-274-6616
Practice Address - Fax:607-274-6620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY261QP0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00356258Medicaid
000900819000OtherHEALTH NOW
7744090OtherAETNA
7744090OtherAETNA