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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

Other

Enumeration date
11/30/2017
Last updated
11/30/2017
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