Provider Demographics
NPI:1972541365
Name:TRUSTEES OF COLUMBIA UNIVERSITY
Entity Type:Organization
Organization Name:TRUSTEES OF COLUMBIA UNIVERSITY
Other - Org Name:PHYS. CARE PYCH LIASON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:
Authorized Official - Last Name:MUSKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-305-9985
Mailing Address - Street 1:622 W 168TH ST
Mailing Address - Street 2:MAILBOX 427
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3720
Mailing Address - Country:US
Mailing Address - Phone:212-305-9985
Mailing Address - Fax:212-305-1249
Practice Address - Street 1:177 FORT WASHINGTON AVE
Practice Address - Street 2:MILSTEIN HOSPITAL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3733
Practice Address - Country:US
Practice Address - Phone:212-305-9985
Practice Address - Fax:212-305-1249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWEP921Medicare ID - Type UnspecifiedPHYS CARE PHYCH LIASON