MEDICARE: TRUSTEES OF COLUMBIA UNIVERSITY ADULT EKG GROUP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558440123
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRUSTEES OF COLUMBIA UNIVERSITY ADULT EKG GROUP

Provider Business Mailing Address
First Line	:	ADULT EKG GROUP CARDIOLOGY DIVISION
Second Line	:	GPO BOX 27050
City	:	NEW YORK
State	:	NY
Zip	:	10087-7050
Country	:	US
Telephone Number	:	212-305-7634
Fax Number	:	212-305-3137

Provider Business Practice Location Address
First Line	:	622 WEST 168TH STREET
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10032-3702
Country	:	US
Telephone Number	:	212-305-7634
Fax Number	:	212-305-3137

Authorized Official
Title or Position	:	CHAIRMAN DIVISION OF CARDIOLOGY
Name	:	DR. ALLAN SCHWARTZ
Credential	:	M.D.
Telephone Number	:	212-305-7634

Provider Enumeration Date	:	11/03/2006
Last Update Date	:	03/29/2011

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