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Organization
WEILL MEDICAL COLLEGE OF CORNELL
Active
Organization
WEILL MEDICAL COLLEGE OF CORNELL
Active
Other names
Cornell Emer. Dept Tox. Physicians
Organization subpart
No
Provider details
NPI number
Authorized official
FABIANE DE SOUZA (ENROLLMENT & CREDENTIALING COORD.)
(646) 962-2543
Entity
Organization
Contact information
Practice address
525 E 68TH ST, NEW YORK, NY 10065-4870
(212) 746-0780
Mailing address
575 LEXINGTON AVE RM 540, NEW YORK, NY 10022-6145
(646) 962-2543
Taxonomy
Speciality
Code
Description
License number
State
207PT0002X
Medical Toxicology (Emergency Medicine) Physician
Primary
—
NULL
207PT0002X
Medical Toxicology (Emergency Medicine) Physician
Primary
—
—
Other
Enumeration date
11/30/2017
Last updated
11/30/2017
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