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FAMILY MEDICINE ASSOCIATES STATE ST
NPI 1013324318
Non-Pharmacy Dispensing Site in Ithaca, NY

Active since July 18, 2014
209 W STATE ST, ITHACA, NY 14850(607) 277-4341 Get Directions Write a Review

NPPES record last updated: July 21, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Family Medicine Associates State St NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FAMILY MEDICINE ASSOCIATES STATE ST (NPI 1013324318) is a healthcare organization registered as a non-pharmacy dispensing site in Ithaca, New York and active in the NPI registry since July 2014. The organization lists Kenny Heine, Vp Of Operations, as its authorized official.

NPPES Registry Identity

NPI1013324318
Entity TypeOrganization
Primary Taxonomy332900000X
Legal Business NameFAMILY MEDICINE ASSOCIATES OF ITHACA
Location Address209 W STATE STIthaca, NY 14850-5429
Mailing Address5626 Oberlin Dr, Suite 110San Diego, CA 92121-1705
Phone(607) 277-4341
Organization SubpartYesParent: Medvantx, Inc.
Authorized OfficialKenny HeineVp Of Operations · (858) 964-1506
Enumeration DateJuly 18, 2014
Last NPPES UpdateJuly 21, 2014
✔ NPI 1013324318 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNon-Pharmacy Dispensing SiteSuppliers
Taxonomy Code332900000X
License✔ Licensed in NY · 143456
Definition
A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)
209 W STATE ST, Ithaca, NY 14850
Open in Google Maps ↗

Other Names 1

Doing Business AsFamily Medicine Associates State St

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JUDITH SCHERER NP FNP
Nurse Practitioner (Family)
209 W STATE ST
ITHACA, NY 14850
Tompkins County (607) 257-5263
SHARON L ZIEGLER MD
Family Medicine
209 W STATE ST, ATTN: BOB BLOOM
ITHACA, NY 14850
Tompkins County (607) 277-4341
SARAH BATSCHELET
Nurse Practitioner (Community Health)
209 W STATE ST
ITHACA, NY 14850
Tompkins County (607) 277-4341
JUSTINE M HILSDORF NP -C
Nurse Practitioner (Family)
209 W STATE ST
ITHACA, NY 14850
Tompkins County (607) 257-5263
ALAN T MIDURA M.D.
Family Medicine
209 W STATE ST
ITHACA, NY 14850
Tompkins County (607) 257-5263
FAMILY MEDICINE ASSOCIATES OF ITHACA LLP
Family Medicine
209 W STATE ST
ITHACA, NY 14850
Tompkins County (607) 257-5263
NEIL FREDERICK SHALLISH M.D.
Family Medicine
209 W STATE ST
ITHACA, NY 14850
Tompkins County (607) 277-4341
CHRISTINE LEIGH MONACELLI FNP
Nurse Practitioner (Family)
209 W STATE ST
ITHACA, NY 14850
Tompkins County (607) 277-4341

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Family Medicine Associates Of Ithaca's NPI number?

The NPI number for Family Medicine Associates Of Ithaca is 1013324318. It was assigned to this organization in the NPPES registry on July 18, 2014. The provider is doing business as Family Medicine Associates State St.

Where is Family Medicine Associates Of Ithaca located?

Family Medicine Associates Of Ithaca is located at 209 W State St, Ithaca, NY 14850. The listed phone number is (607) 277-4341.

What is Family Medicine Associates Of Ithaca's specialty?

The primary specialty registered for this NPI is Non-Pharmacy Dispensing Site with taxonomy code 332900000X.

When was this NPI record last updated?

The NPPES record for Family Medicine Associates Of Ithaca was last updated on July 21, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.