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Organization

WEILL MEDICAL COLLEGE OF CORNELL

Active
Other names
WCUMC DERMATOLOGY GRP.
Organization subpart
No

Provider details

NPI number
Authorized official
CHRISTOPHER T. KELLS (ASSOCIATE DIRECTOR)
(212) 590-5741
Entity
Organization

Contact information

Practice address
1305 YORK AVE, NEW YORK, NY 10021-5663
(212) 746-3016
(212) 746-8656
Mailing address
575 LEXINGTON AVE, SUITE 540, NEW YORK, NY 10022-6102
(212) 590-5710
(212) 590-5798

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
207ND0101X
MOHS-Micrographic Surgery Physician
207ND0900X
Dermatopathology Physician
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
207NP0225X
Pediatric Dermatology Physician
207NS0135X
Procedural Dermatology Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02710369
NY
Enumeration date
05/05/2006
Last updated
07/16/2013
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