Healthcare Provider Details

I. General information

NPI: 1356171797
Provider Name (Legal Business Name): COLUMBIA/NEWYORK-PRESBYTERIAN ADVANCED IMAGING INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2024
Last Update Date: 04/21/2025
Certification Date: 04/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

722 W 168TH ST
NEW YORK NY
10032-3727
US

IV. Provider business mailing address

400 KELBY ST STE 9
FORT LEE NJ
07024-2938
US

V. Phone/Fax

Practice location:
  • Phone: 212-342-2889
  • Fax: 212-342-3745
Mailing address:
  • Phone: 212-304-6308
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: DR. AJAY GUPTA
Title or Position: CHAIR
Credential: MD
Phone: 212-304-6308