Healthcare Provider Details

I. General information

NPI: 1619364957
Provider Name (Legal Business Name): WEILL MEDICAL COLLEGE OF CORNELL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2015
Last Update Date: 04/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

186 JORALEMON ST
BROOKLYN NY
11201-4356
US

IV. Provider business mailing address

575 LEXINGTON AVE SUITE 500
NEW YORK NY
10022-6102
US

V. Phone/Fax

Practice location:
  • Phone: 718-858-3263
  • Fax: 718-858-5095
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. ANN ADENBAUM
Title or Position: SENIOR DIRECTOR
Credential:
Phone: 212-590-5780