Provider Demographics
NPI:1578639423
Name:CAYUGA EMERGENCY PHYSICIANS, LLP
Entity Type:Organization
Organization Name:CAYUGA EMERGENCY PHYSICIANS, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LLP MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-253-5358
Mailing Address - Street 1:75 REMIT DRIVE
Mailing Address - Street 2:SUITE 1248
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60675-1248
Mailing Address - Country:US
Mailing Address - Phone:800-701-3381
Mailing Address - Fax:239-939-1682
Practice Address - Street 1:1129 COMMONS AVE
Practice Address - Street 2:
Practice Address - City:CORTLAND
Practice Address - State:NY
Practice Address - Zip Code:13045-1651
Practice Address - Country:US
Practice Address - Phone:607-274-3100
Practice Address - Fax:607-756-7240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-24
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03012553Medicaid
NYBA1087Medicare PIN