ITHACA MEDICAL GROUP, PLLC (NPI# 1962561951) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962561951 |
| Entity Type | Organization |
| Organization Name | ITHACA MEDICAL GROUP, PLLC |
| Practice Address |
1301 Trumansburg Rd Suite P Ithaca NY 14850-1397 |
| Mailing Address |
201 Harris B Dates Dr Suite 102 Ithaca NY 14850-1345 |
| Practice Telephone | 6072725414 |
| Practice Fax Number | 6072726121 |
| Mailing Telephone | 6072725414 |
| Mailing Fax Number | 6072726121 |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2008-10-28 |
| Authorized Official Name | DR. CHARLES LABE GARBO (OWNER) |
| Authorized Official Telephone | 6072725414 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | NY | Allopathic & Osteopathic Physicians |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | ITHACA MEDICAL GROUP, PLLC | P.o. Box 4507, Ithaca, New York 14852 |
| Street Address |
1301 TRUMANSBURG RD SUITE P |
| City | ITHACA |
| State | NY |
| Zip Code | 14850-1397 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164424362 | Christopher L Peck | Physician Assistant | 1301 Trumansburg Rd, Ste E, Ithaca, NY 14850-1397 | 2005-06-01 |
| 1992167498 | Mohamad Eyad Khorki | Pediatrics | 1301 Trumansburg Rd, Ithaca, NY 14850-1397 | 2016-03-23 |
| 1760842314 | Samara Touchton | Nurse Practitioner | 1301 Trumansburg Rd, Suite P, Ithaca, NY 14850-1397 | 2016-02-24 |
| 1922493097 | Sapan Shah | Anesthesiology | 1301 Trumansburg Rd, Ithaca, NY 14850-1397 | 2015-04-05 |
| 1417264623 | Erin Lovejoy | Physician Assistant | 1301 Trumansburg Rd, Suite R, Ithaca, NY 14850-1397 | 2010-09-09 |
| 1528371291 | Andrea Beth Sharkness | Nurse Practitioner | 1301 Trumansburg Rd, Suite H, Ithaca, NY 14850-1397 | 2010-07-22 |
| 1992943153 | Brian Bollo | Surgery | 1301 Trumansburg Rd, Suite E, Ithaca, NY 14850-1397 | 2009-01-27 |
| 1851571061 | Franciscan Health Support, Inc | Durable Medical Equipment & Medical Supplies | 1301 Trumansburg Rd, Ithaca, NY 14850-1397 | 2007-11-06 |
| 1568591352 | Scott Noren | Dentist | 1301 Trumansburg Rd, Suite # G, Ithaca, NY 14850-1397 | 2007-03-05 |
| 1306925912 | Arthur Richard George | Physician Assistant | 1301 Trumansburg Rd, Suite R, Ithaca, NY 14850-1397 | 2006-11-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174123897 | Michelle Lee Sanito | Registered Nurse | 400 Lake Street, Ithaca, NY 14850 | 2020-10-30 |
| 1457959843 | Summit Alternatives Lmsw PC | Community/Behavioral Health | 215 North Cayuga Street, 2nd Floor Business Complex, Ithaca, NY 14850 | 2020-10-16 |
| 1518581701 | Sameer Acharya | Student in an Organized Health Care Education/Training Program | Internal Medicine Residency, Cayuga Medical Center, 101 Dates Drive, Ithaca, NY 14850 | 2020-06-03 |
| 1699399873 | Anurag Aryal | Student in an Organized Health Care Education/Training Program | 101 Dates Drive Internal Medicine Residency, Cayuga Med, Ithaca, NY 14850 | 2020-06-03 |
| 1932723228 | Binay Kumar Kshetree | Student in an Organized Health Care Education/Training Program | Cayuga Medical Center, 101 Dates Drive, Ithaca, NY 14850 | 2020-06-02 |
| 1225657349 | Nima Hazrati Pour Fard | Student in an Organized Health Care Education/Training Program | Internal Medicine Residency Cayuga Medical Center, 101, Ithaca, NY 14850 | 2020-04-09 |
| 1326671090 | Garret Hoskey | Specialist/Technologist | 953 Dany Road, Ithaca, NY 14850 | 2020-02-20 |
| 1609407709 | En-ting Hsu | Marriage & Family Therapist | 110 N. Cayuga Street 4th Floor Suite 3, Ithaca, NY 14850 | 2020-01-28 |
| 1306491063 | Patrick Owen Mckeon | Specialist/Technologist | Hill Center G66, 953 South Danby Rd., Ithaca, NY 14850 | 2019-08-08 |
| 1538722343 | Priyesh Thakurathi | Student in an Organized Health Care Education/Training Program | 101 Dates Drive Cayuga Medical Center, Internal Medicine Residency Program, Ithaca, NY 14850 | 2019-04-17 |
| Find all providers in zip 14850 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902150550 | Delia Kenkel | Internal Medicine | 28 Chase Ln, Ithaca, NY 14850 | 2012-11-05 |
| 1114172038 | Lavanya Kodali | Internal Medicine | 201 Dates Dr Ste 101, Ithaca, NY 14850-1345 | 2008-11-19 |
| 1184842841 | John Christopher Cusick | Internal Medicine | 8 Cornell Walk, Ithaca, NY 14850-6145 | 2007-04-20 |
| 1972654119 | Geoffrey C Whiting | Internal Medicine | 403 E Buffalo St, Ithaca, NY 14850-4370 | 2007-01-15 |
| 1871674762 | Carl Judson Kilgore | Internal Medicine | 225 Cliff Park Rd, Ithaca, NY 14850-3148 | 2006-10-18 |
| 1205924750 | Janette J Lee | Internal Medicine | 1301 Trumansburg Rd Ste R, Ithaca, NY 14850-1397 | 2006-10-10 |
| 1053413120 | New York Em-iii Medical Services, PC | Internal Medicine | 101 Dates Dr., Ithaca, NY 14850 | 2006-09-01 |
| 1508883208 | Radomir D Stevanovic | Internal Medicine | 2343 N Triphammer Rd, Ithaca, NY 14850-1092 | 2006-07-17 |
| 1376514919 | James Macmillan | Internal Medicine | Cornell University Health Services, Ho Plaza, Ithaca, NY 14853-3101 | 2006-01-31 |
| 1114907847 | Timothy M Cardina | Internal Medicine | 821 Cliff St, Ithaca, NY 14850-2017 | 2006-01-19 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.