DR. DONNA R. SANDIDGE M.D.
Allergy and Immunology
Ithaca, New York
Provider NPI: 1770557209
Provider Information:DR. DONNA R. SANDIDGE M.D.
Practice Location:
310 TAUGHANNOCK BLVD SUITE 310 ITHACA, NY 14850 US
Tel: 607-252-3590 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 207R00000X | Physicians Internal Medicine | NY | 220140 |
Other Provider Identifiers:
| Issuer | Number | State | Type |
|---|---|---|---|
| RR MEDICARE PIN | 030004925 | NY | 01 |
| 02154516 | NY | 05 | |
| 0018306520001 | PA | 05 | |
| RR MEDICARE GROUP | CC8362 | NY | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
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