Healthcare Provider Details

I. General information

NPI: 1508118662
Provider Name (Legal Business Name): WEILL MEDICAL COLLEGE OF CORNELL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2012
Last Update Date: 10/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 YORK AVE 4TH FLOOR
NEW YORK NY
10021-5663
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 646-962-5325
  • Fax: 646-962-0363
Mailing address:
  • Phone: 646-962-5325
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State

VIII. Authorized Official

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