Provider Demographics
NPI:1053435115
Name:TOMPKINS COUNTY HEALTH DEPARTMENT
Entity type:Organization
Organization Name:TOMPKINS COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PUBLIC HEALTH ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRINNELL CROSBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-274-6677
Mailing Address - Street 1:401 DATES DR
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-1344
Mailing Address - Country:US
Mailing Address - Phone:607-274-6641
Mailing Address - Fax:607-274-6648
Practice Address - Street 1:55 BROWN RD
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-1247
Practice Address - Country:US
Practice Address - Phone:607-274-6641
Practice Address - Fax:607-274-6648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00356258Medicaid