DERMATOLOGY ASSOCIATES OF ITHACA, LLC
NPI 1609170992
Dermatology in Ithaca, NY

Q: What is Dermatology Associates Of Ithaca, LLC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Active since January 01, 2011CLIA 33D2112822 · Microscopy

1051 CRAFT RD, ITHACA, NY 14850(607) 257-1107(607) 257-0369 Get Directions Write a Review

NPPES record last updated: October 9, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 9, 2024, Feb 23, 2023, Feb 16, 2023 (3 updates tracked since 2023).

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About Dermatology Associates Of Ithaca, Llc NPPES

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

DERMATOLOGY ASSOCIATES OF ITHACA, LLC (NPI 1609170992) is a healthcare organization registered as a dermatology in Ithaca, New York and active in the NPI registry since January 2011. The organization holds a CLIA Microscopy certificate valid through March 26, 2027, maintains a secondary practice location in Cortland, and lists Katie Terrazas, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1609170992

Entity TypeOrganization

Primary Taxonomy207N00000X

Legal Business NameDERMATOLOGY ASSOCIATES OF ITHACA, LLC

Location Address1051 CRAFT RDIthaca, NY 14850-1016

Mailing Address1051 Craft RdIthaca, NY 14850-1016 · (607) 257-1107 · Fax (607) 257-0369

Phone(607) 257-1107

Fax(607) 257-0369

Organization SubpartNo

Authorized OfficialKatie TerrazasOffice Manager · (607) 257-1107

Enumeration DateJanuary 1, 2011

Last NPPES UpdateOctober 9, 20243 updates tracked since enumeration

NPPES CertifiedOctober 9, 2024

✔ NPI 1609170992 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians

Taxonomy Code207N00000X

License✔ Licensed in NY · 250861

Definition

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

1051 CRAFT RD, Ithaca, NY 14850

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Secondary Practice Location 1

Location 13773 Luker RdCortland, NY 13045-9398 · Phone (607) 257-1107

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 33D2112822

Dermatology Associates Of Ithaca · Ithaca, NY

Active · expires Mar 26, 2027

CLIA Number33D2112822

Laboratory TypePhysician Office

Certificate Effective DateJune 15, 2021

Certificate Expiration DateMarch 26, 2027

Laboratory DirectorDr. Josephine C. Mcallister

Laboratory Phone(607) 257-1107

Laboratory LocationDermatology Associates Of Ithaca1051 Craft Road, Ithaca, NY 14850

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 5

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

MARK A WERNHAM MS,PA-C

Physician Assistant (Medical)