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General NPI Number Information
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NPI Number | 1790702884
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Entity Type | Organization
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Legal Business Name | TRUSTEES OF COLUMBIA IN THE CITY OF NEW YORK
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Dates
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Enumeration Date | 07/16/2006
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Last Update Date | 03/31/2008
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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 | 212-305-2752
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Fax |
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Provider Business Mailing 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 | 212-305-2752
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE VICE PRESIDENT
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Name | DR. LEE GOLDMAN
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Credential | M.D.
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Telephone | 212-305-2752
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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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