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General NPI Number Information
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NPI Number | 1164692489
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Entity Type | Organization
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Legal Business Name | TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK
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Dates
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Enumeration Date | 03/03/2008
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Last Update Date | 11/16/2012
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Provider Practice Location Address
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Address Line | 161 FORT WASHINGTON AVE, 8TH FLOOR, SUITE 853
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City | NEW YORK
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State | NY
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Zip | 10032-3729
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Country | US
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Telephone | 212-305-1024
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Fax |
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Provider Business Mailing Address
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Address Line | 630 W 168TH ST BOX 4
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City | NEW YORK
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State | NY
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Zip | 10032-3725
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SVP/ CHIEF OPERATING OFFICER
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Name | MR. MARK MCDOUGLE
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Credential |
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Telephone | 212-305-6607
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State | NY
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