Provider Demographics
NPI:1689065401
Name:WEILL MEDICAL COLLEGE OF CORNELL UNIVERSITY
Entity Type:Organization
Organization Name:WEILL MEDICAL COLLEGE OF CORNELL UNIVERSITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CONSTANTIANO
Authorized Official - Middle Name:
Authorized Official - Last Name:IADECOLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-746-6575
Mailing Address - Street 1:430 E 63 ST 6L
Mailing Address - Street 2:
Mailing Address - City:NEWYORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065
Mailing Address - Country:US
Mailing Address - Phone:212-355-9347
Mailing Address - Fax:
Practice Address - Street 1:525 E 68 ST
Practice Address - Street 2:DEPT OF NEUROLOGY
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065
Practice Address - Country:US
Practice Address - Phone:212-746-6546
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-16
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY130996261QM2500X, 261QR1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch