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General NPI Number Information
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NPI Number | 1801074315
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Entity Type | Organization
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Legal Business Name | TRUSTEES OF COLUMBIA UNIVERSITY IN THE DEPARTMENT OF OTOLARYNGOLOGY
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Dates
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Enumeration Date | 02/06/2008
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Last Update Date | 07/30/2015
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Provider Practice Location Address
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Address Line | 180 FORT WASHINGTON AVE. HP7
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City | NEW YORK
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State | NY
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Zip | 10032-3735
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Country | US
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Telephone | 212-305-8568
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Fax |
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Provider Business Mailing Address
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Address Line | 180 FORT WASHINGTON AVE. HP8 ROOM #820
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City | NEW YORK
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State | NY
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Zip | 10032-3735
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Country | US
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Telephone | 212-305-1972
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Fax |
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Authorized Official
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Title or Position | SVP
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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