MEDICARE: TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician
2	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1568017317
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK

Provider Business Mailing Address
First Line	:	400 KELBY ST
Second Line	:
City	:	FORT LEE
State	:	NJ
Zip	:	07024-2943
Country	:	US
Telephone Number	:	212-853-6414
Fax Number	:

Provider Business Practice Location Address
First Line	:	693 WHITE PLAINS RD
Second Line	:
City	:	EASTCHESTER
State	:	NY
Zip	:	10709
Country	:	US
Telephone Number	:	212-326-8518
Fax Number	:

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	DR. JAMES MICHAEL MCKIERNAN
Credential	:	MD
Telephone Number	:	212-305-5526

Provider Enumeration Date	:	08/08/2019
Last Update Date	:	03/18/2026

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Directions to “TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK ” Practice Location

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