Healthcare Provider Details

I. General information

NPI: 1013397082
Provider Name (Legal Business Name): WEILL MEDICAL COLLEGE OF CORNELL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2015
Last Update Date: 06/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 EAST 61ST STREET
NEW YORK NY
10065
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 212-486-6715
  • Fax:
Mailing address:
  • Phone: 646-962-5401
  • Fax: 646-962-0293

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number State

VIII. Authorized Official

Name: ANN F ADENBAUM
Title or Position: SENIOR DIRECTOR
Credential:
Phone: 646-962-5487