Provider Demographics
NPI:1437230141
Name:DAVID ALAN MCCUNE
Entity Type:Organization
Organization Name:DAVID ALAN MCCUNE
Other - Org Name:MCCUNE, AINSLIE & ASSOCIATES PT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARLENE
Authorized Official - Middle Name:A
Authorized Official - Last Name:SACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-257-5009
Mailing Address - Street 1:2359 N TRIPHAMMER RD
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-1059
Mailing Address - Country:US
Mailing Address - Phone:607-257-5009
Mailing Address - Fax:607-257-9985
Practice Address - Street 1:2359 N TRIPHAMMER RD
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-1059
Practice Address - Country:US
Practice Address - Phone:607-257-5009
Practice Address - Fax:607-257-9985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02769753Medicaid
NY02769753Medicaid