Provider Demographics
NPI:1790739217
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:CENTER FOR LIVER DISEASE AND TRANSPLANTATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF COMPLIANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDHUSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:212-305-6788
Mailing Address - Street 1:622 W 168TH ST
Mailing Address - Street 2:PH14 - 105
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3720
Mailing Address - Country:US
Mailing Address - Phone:212-305-6788
Mailing Address - Fax:212-305-9474
Practice Address - Street 1:622 W 168TH ST
Practice Address - Street 2:PH14-C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3720
Practice Address - Country:US
Practice Address - Phone:212-305-0914
Practice Address - Fax:212-305-4343
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-20
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204F00000XAllopathic & Osteopathic PhysiciansTransplant SurgeryGroup - Multi-Specialty
No207RI0008XAllopathic & Osteopathic PhysiciansInternal MedicineHepatologyGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty