Healthcare Provider Details

I. General information

NPI: 1518933092
Provider Name (Legal Business Name): DR. JAMES GARVIN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2006
Last Update Date: 11/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

COLUMBIA UNIVERSITY DEPARTMENT PEDIATRIC 3959 BROADWAY
NEW YORK NY
10032
US

IV. Provider business mailing address

34 E HUDSON AVE
ENGLEWOOD NJ
07631-1815
US

V. Phone/Fax

Practice location:
  • Phone: 212-304-7250
  • Fax: 212-544-1974
Mailing address:
  • Phone: 201-816-9520
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number154330
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: