Provider Demographics
NPI:1477503142
Name:COLUMBIA INTERNAL MEDICINE, PLLC
Entity Type:Organization
Organization Name:COLUMBIA INTERNAL MEDICINE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PADMA
Authorized Official - Middle Name:
Authorized Official - Last Name:SRIPADA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-391-2889
Mailing Address - Street 1:PO BOX 9152
Mailing Address - Street 2:COLUMBIA INTERNAL MEDICINE
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12309-0152
Mailing Address - Country:US
Mailing Address - Phone:518-391-2889
Mailing Address - Fax:518-391-2304
Practice Address - Street 1:4 SPRINGHURST DR
Practice Address - Street 2:
Practice Address - City:EAST GREENBUSH
Practice Address - State:NY
Practice Address - Zip Code:12061-2233
Practice Address - Country:US
Practice Address - Phone:518-391-2889
Practice Address - Fax:518-391-2304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty