Healthcare Provider Details

I. General information

NPI: 1124333182
Provider Name (Legal Business Name): WEILL MEDICAL COLLEGE OF CORNELL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2010
Last Update Date: 07/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 E 70TH ST STARR 4
NEW YORK NY
10021
US

IV. Provider business mailing address

575 LEXINGTON AVE SUITE 540
NEW YORK NY
10022-6102
US

V. Phone/Fax

Practice location:
  • Phone: 212-746-2150
  • Fax: 212-746-8451
Mailing address:
  • Phone: 212-590-5741
  • Fax: 212-590-5798

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0001X
TaxonomyAdvanced Heart Failure and Transplant Cardiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER T. KELLS
Title or Position: ASSOCIATE DIRECTOR BUSINESS OFFICE
Credential:
Phone: 212-590-5741