=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821127630
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COLUMBIA UNIVERSITY HARLEM HOSPITAL
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/05/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 506 MALCOLM X BLVD MLK - 12-108
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10037-1802
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-939-3510
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 506 MALCOLM X BLVD MLK - 12-108
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10037-1802
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ASSISTANT PROFESSOR OF ORTHOPAEDIC
-----------------------------------------------------
Name | DR. FRANK G. GUELLICH
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 212-939-3510
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 282N00000X
-----------------------------------------------------
Taxonomy Name | General Acute Care Hospital
-----------------------------------------------------
License Number | 190694
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------