Provider Demographics
NPI:1538527627
Name:CAYUGA HAND & PHYSICAL THERAPY PC
Entity type:Organization
Organization Name:CAYUGA HAND & PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEON
Authorized Official - Middle Name:D
Authorized Official - Last Name:WOLFF
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:607-229-2165
Mailing Address - Street 1:903 HANSHAW RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-1530
Mailing Address - Country:US
Mailing Address - Phone:607-229-2165
Mailing Address - Fax:607-793-9497
Practice Address - Street 1:903 HANSHAW RD
Practice Address - Street 2:SUITE 3
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-1530
Practice Address - Country:US
Practice Address - Phone:607-229-2165
Practice Address - Fax:607-793-9497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-03
Last Update Date:2016-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ100291553Medicare PIN
NYA100142341Medicare PIN