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General NPI Number Information
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NPI Number | 1710491568
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Entity Type | Organization
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Legal Business Name | WEILL MEDICAL COLLEGE OF CORNELL
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Dates
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Enumeration Date | 11/30/2017
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Last Update Date | 11/30/2017
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Provider Practice Location Address
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Address Line | 525 E 68TH ST
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City | NEW YORK
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State | NY
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Zip | 10065-4870
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Country | US
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Telephone | 212-746-0780
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Fax |
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Provider Business Mailing Address
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Address Line | 575 LEXINGTON AVE RM 540
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City | NEW YORK
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State | NY
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Zip | 10022-6145
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Country | US
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Telephone | 646-962-2543
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Fax |
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Authorized Official
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Title or Position | ENROLLMENT & CREDENTIALING COORD.
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Name | FABIANE DE SOUZA
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Credential |
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Telephone | 646-962-2543
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207PT0002X
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Taxonomy Name | Medical Toxicology (Emergency Medicine) Physician
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License Number |
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License Number State |
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