Provider Demographics
NPI:1912029794
Name:HEALTH SERVICES AT COLUMBIA
Entity Type:Organization
Organization Name:HEALTH SERVICES AT COLUMBIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:SEWARD
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:212-854-3187
Mailing Address - Street 1:519 W 114TH ST
Mailing Address - Street 2:MC 3601
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-7036
Mailing Address - Country:US
Mailing Address - Phone:212-854-3187
Mailing Address - Fax:212-854-3654
Practice Address - Street 1:519 W 114TH ST
Practice Address - Street 2:MC 3601
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-7036
Practice Address - Country:US
Practice Address - Phone:212-854-3187
Practice Address - Fax:212-854-3654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY206332261QS1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health