Provider Demographics
NPI:1174634406
Name:WEILL MEDICAL COLLEGE OF CORNELL
Entity Type:Organization
Organization Name:WEILL MEDICAL COLLEGE OF CORNELL
Other - Org Name:NYHCMC NEUROLOGY CAR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSOCIATE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:T
Authorized Official - Last Name:KELLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-590-5741
Mailing Address - Street 1:520 EAST 70TH ST.
Mailing Address - Street 2:F610
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4870
Mailing Address - Country:US
Mailing Address - Phone:212-746-4599
Mailing Address - Fax:212-746-7813
Practice Address - Street 1:520 EAST 70TH ST.
Practice Address - Street 2:F610
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4870
Practice Address - Country:US
Practice Address - Phone:212-746-4599
Practice Address - Fax:212-746-7813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03448611Medicaid
NYW19381Medicare PIN