National Provider Identifier
Heather Dirienzo, PA-C
Heather Dirienzo, PA-C is listed in the NPPES registry with a primary specialty of Physician Assistant in Ithaca, NY and a listed phone number of (607) 319-5900.
Profile Overview
- NPI
- 1760010169
- Provider Type
- Individual
- Primary Specialty
- Physician Assistant
- Enumeration Date
- March 31, 2020
- Last Updated
- May 14, 2024
Practice Location
- 401 Cayuga Park Ln
- Ithaca, NY 14850-1180
Phone: (607) 319-5900
Specialties
- Physician Assistant (363A00000X)
Full Record
- NPI
- 1760010169
- Entity Type
- Individual
- Last Name
- Dirienzo
- First Name
- Heather
- Credential
- PA-C
- Mailing Street Address
- 401 Cayuga Park Ln
- Mailing City
- Ithaca
- Mailing State
- NY
- Mailing ZIP Code
- 14850-1180
- Mailing Country
- US
- Practice Street Address
- 401 Cayuga Park Ln
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14850-1180
- Practice Country
- US
- Practice Phone
- (607) 319-5900
- Enumeration Date
- March 31, 2020
- Last Updated
- May 14, 2024
- Sex
- Female
- Sole Proprietor
- Yes
- Taxonomy Group 1
- 193200000X Multi-Specialty Group
- Certification Date
- May 14, 2024
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Physician Assistant (363A00000X)