Provider Demographics
NPI:1750308474
Name:CAYUGA FAMILY MEDICINE PC
Entity Type:Organization
Organization Name:CAYUGA FAMILY MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:LOEHR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:607-697-0360
Mailing Address - Street 1:302 W SENECA ST
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-4130
Mailing Address - Country:US
Mailing Address - Phone:607-697-0360
Mailing Address - Fax:607-272-0240
Practice Address - Street 1:302 W SENECA ST
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-4130
Practice Address - Country:US
Practice Address - Phone:607-697-0360
Practice Address - Fax:607-272-0240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02053863Medicaid
NY02053863Medicaid