Provider Demographics
NPI:1326281288
Name:WEILL CORNELL MEDICAL COLLEGE-MALE INFERTILITY GENETICS LABORATORY
Entity Type:Organization
Organization Name:WEILL CORNELL MEDICAL COLLEGE-MALE INFERTILITY GENETICS LABORATORY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LABORATORY DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:N
Authorized Official - Last Name:SCHLEGEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-746-5491
Mailing Address - Street 1:525 E 68TH ST # 94
Mailing Address - Street 2:MALE INFERTILITY GENETICS LABORATORY/DEPARTMENT OF UROL
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-4870
Mailing Address - Country:US
Mailing Address - Phone:212-746-5469
Mailing Address - Fax:212-746-8197
Practice Address - Street 1:525 E 68TH ST RM A900
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-4870
Practice Address - Country:US
Practice Address - Phone:212-746-5309
Practice Address - Fax:212-746-7287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-08
Last Update Date:2009-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY177894291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory