Provider Demographics
NPI:1427165489
Name:WEILL MEDICAL COLLEGE OF CORNELL UNIV.
Entity type:Organization
Organization Name:WEILL MEDICAL COLLEGE OF CORNELL UNIV.
Other - Org Name:<UNAVAIL>
Other - Org Type:
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 1:21 BLOOMINGDALE RD
Mailing Address - Street 2:3A SOUTH
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-1504
Mailing Address - Country:US
Mailing Address - Phone:914-682-9100
Mailing Address - Fax:
Practice Address - Street 1:21 BLOOMINGDALE RD
Practice Address - Street 2:3A SOUTH
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-1504
Practice Address - Country:US
Practice Address - Phone:914-682-9100
Practice Address - Fax:
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?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW 3 3 7 8 2Medicare ID - Type UnspecifiedMEDICARE GRP.NUMBER