# WEILL MEDICAL COLLEGE OF CORNELL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Cornell Emer. Dept Tox. Physicians
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710491568
- **Authorized official:** FABIANE DE SOUZA (ENROLLMENT & CREDENTIALING COORD.)
- **Authorized official phone:** (646) 962-2543

## Contact information

- **Practice address:** 525 E 68TH ST, NEW YORK, NY 10065-4870
- **Practice address phone:** (212) 746-0780
- **Mailing address:** 575 LEXINGTON AVE RM 540, NEW YORK, NY 10022-6145
- **Mailing address phone:** (646) 962-2543

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207PT0002X | Medical Toxicology (Emergency Medicine) Physician | — | NULL | Yes |
| 207PT0002X | Medical Toxicology (Emergency Medicine) Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/30/2017
- **Last updated:** 11/30/2017