Provider Demographics
NPI:1366614562
Name:TRUSTEES OF COLUMBIA UNIVERSITY, RAD. DEPT.
Entity type:Organization
Organization Name:TRUSTEES OF COLUMBIA UNIVERSITY, RAD. DEPT.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DEPARTMENT ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:AREN
Authorized Official - Middle Name:
Authorized Official - Last Name:LALJIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-305-1948
Mailing Address - Street 1:630 W 168TH ST # MC28
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3725
Mailing Address - Country:US
Mailing Address - Phone:212-305-1948
Mailing Address - Fax:212-305-5777
Practice Address - Street 1:710 W 168TH ST # B-41
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3726
Practice Address - Country:US
Practice Address - Phone:212-342-0299
Practice Address - Fax:212-342-0851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-27
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02186203Medicaid
NYW35021Medicare PIN