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General NPI Number Information
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NPI Number | 1477680841
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Entity Type | Organization
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Legal Business Name | DERMATOLOGY CLINICIANS GROUP - COLUMBIA UNIVERSITY
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 08/25/2009
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Provider Practice Location Address
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Address Line | 161 FORT WASHINGTON AVE 12TH FLOOR
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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 | 212-305-0505
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 27429
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City | NEW YORK
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State | NY
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Zip | 10087-7429
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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 | DIRECTOR
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Name | JUSTIN VINCENT FALCO
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Credential |
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Telephone | 212-305-8132
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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