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General NPI Number Information
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NPI Number | 1336276179
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Entity Type | Organization
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Legal Business Name | CORNELL UNIVERSITY
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 10/11/2023
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Provider Practice Location Address
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Address Line | 110 HO PLAZA
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City | ITHACA
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State | NY
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Zip | 14853-3101
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Country | US
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Telephone | 607-255-6976
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Fax | 607-254-5042
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Provider Business Mailing Address
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Address Line | 110 HO PLAZA
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City | ITHACA
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State | NY
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Zip | 14853-3101
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Country | US
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Telephone | 607-255-6976
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Fax | 607-254-5042
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Authorized Official
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Title or Position | DIRECTOR
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Name | JADA M HAMILTON
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Credential | MD
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Telephone | 607-255-7492
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 026826
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License Number State | NY
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