Provider Demographics
NPI:1740287531
Name:GUTHRIE CORTLAND MEDICAL CENTER
Entity type:Organization
Organization Name:GUTHRIE CORTLAND MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:LUCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAGGIOMO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-887-8756
Mailing Address - Street 1:PO BOX 2060
Mailing Address - Street 2:
Mailing Address - City:CORTLAND
Mailing Address - State:NY
Mailing Address - Zip Code:13045-0946
Mailing Address - Country:US
Mailing Address - Phone:607-756-3554
Mailing Address - Fax:607-756-3545
Practice Address - Street 1:134 HOMER AVE
Practice Address - Street 2:
Practice Address - City:CORTLAND
Practice Address - State:NY
Practice Address - Zip Code:13045-1206
Practice Address - Country:US
Practice Address - Phone:607-756-3554
Practice Address - Fax:607-756-3545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY282N00000X
NY=========282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00279176Medicaid
NY330175Medicare ID - Type Unspecified
NY00279176Medicaid