Healthcare Provider Details

I. General information

NPI: 1043388572
Provider Name (Legal Business Name): COLUMBIA UNIVERSITY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 FORT WASHINGTON AVE FL 12
NEW YORK NY
10032-3729
US

IV. Provider business mailing address

40 MOHEGAN ROAD
LARCHMONT NY
10538
US

V. Phone/Fax

Practice location:
  • Phone: 914-833-1121
  • Fax: 212-305-5565
Mailing address:
  • Phone: 212-305-5565
  • Fax: 212-305-4571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1744R1102X
TaxonomyResearch Study Specialist
License Number1071541
License Number StateNY

VIII. Authorized Official

Name: DR. DAVID RINSEY BICKERS
Title or Position: CHAIRMAN
Credential: M.D.
Phone: 212-305-5565