Provider Demographics
NPI:1073584926
Name:CORNELL UNIVERSITY
Entity Type:Organization
Organization Name:CORNELL UNIVERSITY
Other - Org Name:GANNETT HEALTH SERVICES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JADA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:607-255-7492
Mailing Address - Street 1:110 HO PLAZA
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14853
Mailing Address - Country:US
Mailing Address - Phone:607-255-5155
Mailing Address - Fax:607-255-0269
Practice Address - Street 1:110 HO PLAZA
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14853
Practice Address - Country:US
Practice Address - Phone:607-255-5155
Practice Address - Fax:607-255-0269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-30
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health