Provider Demographics
| NPI: | 1508266347 |
|---|---|
| Name: | TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK |
| Entity type: | Organization |
| Organization Name: | TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CEO AND SENIOR VICE DEAN |
| Authorized Official - Prefix: | DR |
| Authorized Official - First Name: | JAMES |
| Authorized Official - Middle Name: | MICHAEL |
| Authorized Official - Last Name: | MCKIERNAN |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | MD |
| Authorized Official - Phone: | 212-305-5526 |
| Mailing Address - Street 1: | 400 KELBY ST |
| Mailing Address - Street 2: | 7TH FLOOR, COLUMBIA CLINICAL REVENUE OFFICE |
| Mailing Address - City: | FORT LEE |
| Mailing Address - State: | NJ |
| Mailing Address - Zip Code: | 07024-2943 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 212-304-6309 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 622 W 168TH ST |
| Practice Address - Street 2: | |
| Practice Address - City: | NEW YORK |
| Practice Address - State: | NY |
| Practice Address - Zip Code: | 10032 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 646-317-7111 |
| Practice Address - Fax: | 212-304-6470 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2014-08-29 |
| Last Update Date: | 2023-02-07 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 208600000X | Allopathic & Osteopathic Physicians | Surgery | Group - Multi-Specialty | |
| No | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Group - Multi-Specialty | |
| No | 204E00000X | Allopathic & Osteopathic Physicians | Oral & Maxillofacial Surgery | Group - Multi-Specialty | |
| No | 207N00000X | Allopathic & Osteopathic Physicians | Dermatology | Group - Multi-Specialty | |
| No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
| No | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Group - Multi-Specialty | |
| No | 207W00000X | Allopathic & Osteopathic Physicians | Ophthalmology | Group - Multi-Specialty | |
| No | 207Y00000X | Allopathic & Osteopathic Physicians | Otolaryngology | Group - Multi-Specialty | |
| No | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | Group - Multi-Specialty | |
| No | 208100000X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Group - Multi-Specialty | |
| No | 2084N0400X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | Group - Multi-Specialty |
| No | 2084P0800X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | Group - Multi-Specialty |
| No | 2085R0001X | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology | Group - Multi-Specialty |
| No | 208800000X | Allopathic & Osteopathic Physicians | Urology | Group - Multi-Specialty | |
| No | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Group - Multi-Specialty |