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General NPI Number Information
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NPI Number | 1376756072
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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 | 05/08/2007
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Last Update Date | 03/18/2026
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Provider Practice Location Address
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Address Line | 630 W 168TH ST SUITE VC7-226
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City | NEW YORK
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State | NY
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Zip | 10032
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Country | US
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Telephone | 212-305-8516
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Fax | 212-305-9017
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Provider Business Mailing Address
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Address Line | 400 KELBY ST
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City | FORT LEE
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State | NJ
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Zip | 07024-2943
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Country | US
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Telephone | 212-853-6414
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | DR. JAMES MICHAEL MCKIERNAN
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Credential | MD
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Telephone | 212-305-5526
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 036028-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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