Healthcare Provider Details

I. General information

NPI: 1356352918
Provider Name (Legal Business Name): TRUSTEES OF COLUMBIA UNIVERSITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 05/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 FT WASHINGTN AVE IP 749
NEW YORK NY
10032-3729
US

IV. Provider business mailing address

161 FT WASHINGTN AVE IP 749
NEW YORK NY
10032-3729
US

V. Phone/Fax

Practice location:
  • Phone: 212-305-8684
  • Fax: 212-305-0397
Mailing address:
  • Phone: 212-305-8684
  • Fax: 212-305-0397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number023275
License Number StateNY

VIII. Authorized Official

Name: ROBERT MACAUTHUR
Title or Position: DIRECTOR OF CPMC RSCH PHCY
Credential: PHARMD
Phone: 212-305-8684