Provider Demographics
NPI:1447521836
Name:WEILL MEDICAL COLLEGE OF CORNELL UNIVERSITY
Entity type:Organization
Organization Name:WEILL MEDICAL COLLEGE OF CORNELL UNIVERSITY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE DIRECTOR POBO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIOPHER
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 LEXINGTON AVE.
Mailing Address - Street 2:SUITE 540
Mailing Address - City:NEW YORK CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10022-6102
Mailing Address - Country:US
Mailing Address - Phone:212-590-5741
Mailing Address - Fax:212-590-5798
Practice Address - Street 1:82 EAST ALLENDALE ROAD
Practice Address - Street 2:SUITE 3A
Practice Address - City:SADDLE RIVER
Practice Address - State:NJ
Practice Address - Zip Code:07458-3057
Practice Address - Country:US
Practice Address - Phone:201-236-1183
Practice Address - Fax:201-236-1460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-18
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty