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General NPI Number Information
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NPI Number | 1730297011
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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 | 08/28/2006
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Last Update Date | 02/02/2015
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Provider Practice Location Address
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Address Line | 722 WEST 168TH STREET R1 FL
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City | NEW YORK
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State | NY
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Zip | 10032-3733
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Country | US
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Telephone | 212-342-2899
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Fax | 212-342-3745
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Provider Business Mailing Address
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Address Line | 630 W 168TH ST # 28
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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 | 212-305-1948
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Fax | 212-305-5777
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Authorized Official
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Title or Position | CREDENTIALING COORDINATOR
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Name | MS. VIRTUDES REYES
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Credential |
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Telephone | 212-305-1948
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085N0904X
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Taxonomy Name | Nuclear Radiology Physician
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License Number |
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License Number State |
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