National Provider Identifier

Cody Mason Herbert, MS, ATC

Cody Mason Herbert, MS, ATC is listed in the NPPES registry with a primary specialty of Athletic Trainer in Ithaca, NY and a listed phone number of (607) 255-4237.

NPI 1104193077Ithaca, NYAthletic Trainer

Profile Overview

NPI
1104193077
Provider Type
Individual
Primary Specialty
Athletic Trainer
Enumeration Date
November 21, 2011
Last Updated
November 21, 2011

Practice Location

  • 512 Campus RD.
  • Teagle Hall
  • Ithaca, NY 14850

Phone: (607) 255-4237

Mailing Address

  • 110 W Marshall St
  • Apt 2
  • Ithaca, NY 14850-3546

Specialties

  • Athletic Trainer (2255A2300X)
Full Record
NPI
1104193077
Entity Type
Individual
Last Name
Herbert
First Name
Cody
Middle Name
Mason
Credential
MS, ATC
Mailing Street Address
110 W Marshall St
Mailing Address Line 2
Apt 2
Mailing City
Ithaca
Mailing State
NY
Mailing ZIP Code
14850-3546
Mailing Country
US
Mailing Phone
(973) 903-7663
Practice Street Address
512 Campus RD.
Practice Address Line 2
Teagle Hall
Practice City
Ithaca
Practice State
NY
Practice ZIP Code
14850
Practice Country
US
Practice Phone
(607) 255-4237
Enumeration Date
November 21, 2011
Last Updated
November 21, 2011
Sex
Male
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Athletic Trainer (2255A2300X)