Provider Demographics
NPI: | 1760444822 |
---|---|
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: | DIRECTOR OF REVENUE CYCLE |
Authorized Official - Prefix: | |
Authorized Official - First Name: | KHALED |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | KADRY |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 212-305-8457 |
Mailing Address - Street 1: | 3959 BROADWAY |
Mailing Address - Street 2: | COLUMBIA UNIVERSITY DEPARTMENT PEDIATRICS |
Mailing Address - City: | NEW YORK |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 10032-1559 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 201-346-7250 |
Mailing Address - Fax: | 201-346-7229 |
Practice Address - Street 1: | 3959 BROADWAY |
Practice Address - Street 2: | COLUMBIA UNIVERSITY DEPARTMENT PEDS |
Practice Address - City: | NEW YORK |
Practice Address - State: | NY |
Practice Address - Zip Code: | 10032-1559 |
Practice Address - Country: | US |
Practice Address - Phone: | 201-346-7250 |
Practice Address - Fax: | 201-346-7229 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-04-04 |
Last Update Date: | 2016-11-07 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 2080P0204X | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Emergency Medicine | Group - Multi-Specialty |
No | 207LP3000X | Allopathic & Osteopathic Physicians | Anesthesiology | Pediatric Anesthesiology | Group - Multi-Specialty |
No | 207SG0203X | Allopathic & Osteopathic Physicians | Medical Genetics | Clinical Molecular Genetics | Group - Multi-Specialty |
No | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | Group - Multi-Specialty | |
No | 2080N0001X | Allopathic & Osteopathic Physicians | Pediatrics | Neonatal-Perinatal Medicine | Group - Multi-Specialty |
No | 2080P0201X | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Allergy/Immunology | Group - Multi-Specialty |
No | 2080P0202X | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Cardiology | Group - Multi-Specialty |
No | 2080P0203X | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Critical Care Medicine | Group - Multi-Specialty |
No | 2080P0205X | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Endocrinology | Group - Multi-Specialty |
No | 2080P0206X | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Gastroenterology | Group - Multi-Specialty |
No | 2080P0207X | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Hematology-Oncology | Group - Multi-Specialty |
No | 2080P0208X | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Infectious Diseases | Group - Multi-Specialty |
No | 2080P0210X | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Nephrology | Group - Multi-Specialty |
No | 2080P0214X | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Pulmonology | Group - Multi-Specialty |
No | 2080P0216X | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Rheumatology | Group - Multi-Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
NY | W38381 | Other | PTAN |
NY | 01391840 | Medicaid | |
NJ | 5996104 | Medicaid |