Ithaca Dermatology PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

220803 Issued in NY

Legal business name

ITHACA DERMATOLOGY PLLC

Practice address

821 Cliff Street
Ithaca, NY 14850

Phone

(607) 256-7546

Fax

(607) 256-0049

NPI assigned

Sep 6, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Kimberly Silvers

Title

Owner

Phone

(607) 256-7546

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1189036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264550400000",
    "number": "1790979417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 TAUGHANNOCK BLVD",
            "address_2": "PO BOX 366",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "14851",
            "telephone_number": "607-277-4035",
            "fax_number": "607-277-3888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 CLIFF STREET",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "14850",
            "telephone_number": "607-256-7546",
            "fax_number": "607-256-0049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ITHACA DERMATOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-06",
        "last_updated": "2010-01-27",
        "status": "A",
        "authorized_official_last_name": "SILVERS",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "607-256-7546",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "NY",
            "license": "220803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Ithaca, NY
• Providers in Ithaca, NY by specialty
• Dermatology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.