Provider Demographics
NPI: | 1265598783 |
---|---|
Name: | THE TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK |
Entity type: | Organization |
Organization Name: | THE TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | EXECUTIVE VICE PRESIDENT |
Authorized Official - Prefix: | |
Authorized Official - First Name: | LEE |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | GOLDMAN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 212-305-2752 |
Mailing Address - Street 1: | 400 KELBY STREET, BOX 47 |
Mailing Address - Street 2: | COLUMBIA UNIVERSITY, 11TH FLOOR |
Mailing Address - City: | FORT LEE |
Mailing Address - State: | NJ |
Mailing Address - Zip Code: | 07024-2938 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 212-305-6625 |
Mailing Address - Fax: | 212-304-7819 |
Practice Address - Street 1: | 161 FORT WASHINGTON AVE |
Practice Address - Street 2: | 8TH FLOOR |
Practice Address - City: | NEW YORK |
Practice Address - State: | NY |
Practice Address - Zip Code: | 10032-3729 |
Practice Address - Country: | US |
Practice Address - Phone: | 212-305-6625 |
Practice Address - Fax: | 212-304-7819 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-12-29 |
Last Update Date: | 2017-10-30 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 208600000X | Allopathic & Osteopathic Physicians | Surgery | Group - Multi-Specialty | |
No | 204F00000X | Allopathic & Osteopathic Physicians | Transplant Surgery | Group - Multi-Specialty | |
No | 207RG0100X | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | Group - Single Specialty |
No | 207RT0003X | Allopathic & Osteopathic Physicians | Internal Medicine | Transplant Hepatology | Group - Single Specialty |
No | 2080T0004X | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Transplant Hepatology | Group - Single Specialty |
No | 2084P0800X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | Group - Single Specialty |
No | 2086S0102X | Allopathic & Osteopathic Physicians | Surgery | Surgical Critical Care | Group - Single Specialty |
No | 2086S0120X | Allopathic & Osteopathic Physicians | Surgery | Pediatric Surgery | Group - Multi-Specialty |
No | 2086S0122X | Allopathic & Osteopathic Physicians | Surgery | Plastic and Reconstructive Surgery | Group - Multi-Specialty |
No | 2086S0129X | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery | Group - Multi-Specialty |
No | 2086X0206X | Allopathic & Osteopathic Physicians | Surgery | Surgical Oncology | Group - Multi-Specialty |
No | 208C00000X | Allopathic & Osteopathic Physicians | Colon & Rectal Surgery | Group - Multi-Specialty | |
No | 208G00000X | Allopathic & Osteopathic Physicians | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Group - Multi-Specialty | |
No | 363LA2200X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health | Group - Single Specialty |
No | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | Group - Single Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
NY | DO0751 | Other | RAILROAD MEDICARE |
NY | 03179908 | Medicaid | |
NY | 03179908 | Medicaid | |
NY | 03179908 | Medicaid |