OrganizationActive
24 on Physician New York, PC
NPI 1285799163 · Internal Medicine Physician · Ithaca, NY
Provider details
- NPI number
- 1285799163
- Entity type
- Organization
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Authorized official
- Dan Fuller, President
Practice location
101 Dates Dr
Ithaca, NY 14850-1342
Phone: (607) 274-4191
Fax: (607) 274-4198
Mailing address
Po Box 403631
Atlanta, GA 30384-3631
Registry dates
- Enumerated
- 2006-12-22
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.