Provider Demographics
NPI:1124170212
Name:WEILL MEDICAL COLLEGE OF CORNELL
Entity type:Organization
Organization Name:WEILL MEDICAL COLLEGE OF CORNELL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR DIRECTOR POBO
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:F
Authorized Official - Last Name:ADENBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-962-5487
Mailing Address - Street 1:PO BOX 30107
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-0107
Mailing Address - Country:US
Mailing Address - Phone:646-962-5487
Mailing Address - Fax:646-962-0293
Practice Address - Street 1:1300 YORK AVE
Practice Address - Street 2:BOX 585
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4805
Practice Address - Country:US
Practice Address - Phone:212-590-5741
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
No207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW12933Medicare PIN
NYW79831Medicare PIN
NYW33781Medicare PIN
NYW8D201Medicare PIN
NYWEG361Medicare PIN
NYWKW341Medicare PIN
NYW05951Medicare PIN
NYWO7031Medicare PIN
NYW09611Medicare PIN
NYW09551Medicare PIN
NYW19381Medicare PIN
NYW23571Medicare PIN
NYW2I541Medicare PIN
NYWCW101Medicare PIN
NYW05261Medicare PIN
NYW06471Medicare PIN
NYW12931Medicare PIN
NYW07911Medicare PIN
NYWJW441Medicare PIN
NYWKW331Medicare PIN