Provider Demographics
NPI:1235246232
Name:WEILL MEDICAL COLLEGE OF CORNELL UNIVERSITY
Entity Type:Organization
Organization Name:WEILL MEDICAL COLLEGE OF CORNELL UNIVERSITY
Other - Org Name:CORNELL OPHTHALMOLOGY ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING ASSOICATES
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIOPHER
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 1:525 E 68TH ST
Mailing Address - Street 2:F838A S.PELTON
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4870
Mailing Address - Country:US
Mailing Address - Phone:212-746-2868
Mailing Address - Fax:212-746-8125
Practice Address - Street 1:525 E 68TH ST
Practice Address - Street 2:F838A S.PELTON
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4870
Practice Address - Country:US
Practice Address - Phone:212-746-2868
Practice Address - Fax:212-746-8125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty