Provider Demographics
NPI:1710910906
Name:TRUSTEES OF COLUMBIA UNIVERISTY IN THE CITY OF NEW YORK ASSOCIATES
Entity Type:Organization
Organization Name:TRUSTEES OF COLUMBIA UNIVERISTY IN THE CITY OF NEW YORK ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:WATERMAN
Authorized Official - Last Name:BLATNIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-305-2995
Mailing Address - Street 1:622 WEST 168 ST. PH 1-137
Mailing Address - Street 2:ASSOCIATES IN EMERGENCY SERVICES @CUMC
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032
Mailing Address - Country:US
Mailing Address - Phone:212-305-2995
Mailing Address - Fax:212-305-6792
Practice Address - Street 1:622 WEST 168 ST. PH 1-137
Practice Address - Street 2:COLUMBIA UNIVERSITY MEDICAL CENTER
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032
Practice Address - Country:US
Practice Address - Phone:212-305-2995
Practice Address - Fax:212-305-6792
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02441918Medicaid
NY02441918Medicaid