Provider Demographics
NPI:1558440123
Name:TRUSTEES OF COLUMBIA UNIVERSITY ADULT EKG GROUP
Entity Type:Organization
Organization Name:TRUSTEES OF COLUMBIA UNIVERSITY ADULT EKG GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN DIVISION OF CARDIOLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-305-7634
Mailing Address - Street 1:ADULT EKG GROUP CARDIOLOGY DIVISION
Mailing Address - Street 2:GPO BOX 27050
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-7050
Mailing Address - Country:US
Mailing Address - Phone:212-305-7634
Mailing Address - Fax:212-305-3137
Practice Address - Street 1:622 WEST 168TH STREET
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3702
Practice Address - Country:US
Practice Address - Phone:212-305-7634
Practice Address - Fax:212-305-3137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02444879Medicaid
NY02444879Medicaid