Healthcare Provider Details

I. General information

NPI: 1053896613
Provider Name (Legal Business Name): ASHLEY EZEMA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2018
Last Update Date: 03/29/2022
Certification Date: 03/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WEILL CORNELL INTERNAL MEDICINE ASSOCIATES 505 EAST 70TH STREET
NEW YORK NY
10021
US

IV. Provider business mailing address

WEILL CORNELL INTERNAL MEDICINE ASSOCIATES 505 EAST 70TH STREET
NEW YORK NY
10021
US

V. Phone/Fax

Practice location:
  • Phone: 212-746-2900
  • Fax: 212-746-4609
Mailing address:
  • Phone: 212-746-2900
  • Fax: 212-746-4609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: