Provider Demographics
NPI:1619010014
Name:TTPM, INC
Entity Type:Organization
Organization Name:TTPM, INC
Other - Org Name:TWIN TIER PHYSCIAN MANAGEMENT,INC
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:L
Authorized Official - Last Name:OSTRANDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-733-6094
Mailing Address - Street 1:530 W CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14905-2526
Mailing Address - Country:US
Mailing Address - Phone:607-733-6094
Mailing Address - Fax:607-732-1812
Practice Address - Street 1:530 W CHURCH ST
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14905-2526
Practice Address - Country:US
Practice Address - Phone:607-733-6094
Practice Address - Fax:607-732-1812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247000000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Health InformationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYCI0915OtherPALMETTO GBA
NY470000999OtherPALMETTO GBA
NY01072673Medicaid
NY51097AMedicare ID - Type Unspecified
NY01072673Medicaid