Organization
CORNELL UNIV MED COLLEGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER KELLS (ASSOCIATE DIRECTOR)
(212) 590-5741
Entity
Organization
Contact information
Practice address
56 W 45TH ST, 9TH FLOOR, NEW YORK, NY 10036-4206
(212) 764-5178
(212) 764-5644
Mailing address
56 W 45TH ST, 9TH FLOOR, NEW YORK, NY 10036-4206
(212) 764-5178
(212) 764-5644
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
070611059
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01439358
—
NY
Enumeration date
06/26/2007
Last updated
08/08/2008
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