Provider Demographics
NPI: | 1447502547 |
---|---|
Name: | WEILL MEDICAL COLLEGE OF CORNELL |
Entity type: | Organization |
Organization Name: | WEILL MEDICAL COLLEGE OF CORNELL |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | ASSOCIATE DIRECTOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | CHRISTOPHER |
Authorized Official - Middle Name: | T |
Authorized Official - Last Name: | KELLS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 212-590-5741 |
Mailing Address - Street 1: | 575 LEXINTON AVE. |
Mailing Address - Street 2: | SUITE 540 |
Mailing Address - City: | NEW YORK |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 10022-6102 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 646-962-5325 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1305 YORK AVE. |
Practice Address - Street 2: | 4TH FLOOR |
Practice Address - City: | NEW YORK |
Practice Address - State: | NY |
Practice Address - Zip Code: | 10021-5663 |
Practice Address - Country: | US |
Practice Address - Phone: | 646-962-5325 |
Practice Address - Fax: | 646-962-0363 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2012-10-12 |
Last Update Date: | 2012-10-12 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207RI0200X | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease | Group - Multi-Specialty |