Provider Demographics
NPI:1386415511
Name:CAYUGA HEALTH SYSTEM
Entity type:Organization
Organization Name:CAYUGA HEALTH SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTY
Authorized Official - Middle Name:
Authorized Official - Last Name:STALLONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:607-274-4296
Mailing Address - Street 1:111 ORCHARD ST
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-2733
Mailing Address - Country:US
Mailing Address - Phone:607-342-8142
Mailing Address - Fax:
Practice Address - Street 1:2432 N TRIPHAMMER RD
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-1014
Practice Address - Country:US
Practice Address - Phone:607-272-0460
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty