Ithaca Health Alliance

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

ITHACA HEALTH ALLIANCE

Doing business as

Ithaca Free Clinic

Practice address

521 W Seneca St
Ithaca, NY 14850-4033

Phone

(607) 330-1254

Fax

(607) 330-1194

NPI assigned

Apr 9, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Norbert G McCloskey, EXECUTIVE DIRECTOR

Title

Executive Director

Phone

(607) 882-9060

Specialties & licenses 1

Addresses

Other names 1

• Ithaca Free Clinic Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1554768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554768000000",
    "number": "1306309000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 W SENECA ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148504033",
            "telephone_number": "607-330-1254",
            "fax_number": "607-330-1194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 W SENECA ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148504033",
            "telephone_number": "607-330-1254",
            "fax_number": "607-330-1194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ITHACA HEALTH ALLIANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-09",
        "last_updated": "2019-04-09",
        "status": "A",
        "authorized_official_last_name": "MCCLOSKEY",
        "authorized_official_first_name": "NORBERT",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "607-882-9060",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "EXECUTIVE DIRECTOR"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ithaca Free Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ithaca City School District
• Ithaca College Student Health Services
• Ithaca Dentistry, PLLC
• Ithaca Dermatology PLLC
• Ithaca Eye Care Optometry PLLC
• Ithaca Inpatient Physicians
• Ithaca Medical Group, PLLC
• Ithaca Medical Services PLLC
• Ithaca Orthopaedic Group, PC
• Ithaca Outpatient Clinic

• Health Service Clinic/Center in Ithaca, NY
• Providers in Ithaca, NY by specialty
• Health Service Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.