Provider Demographics
NPI:1932368214
Name:THE TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK
Entity Type:Organization
Organization Name:THE TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK
Other - Org Name:COLUMBIA UNIVERSITY LABORATORIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:C
Authorized Official - Last Name:MARBOE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-305-8063
Mailing Address - Street 1:630 W 168TH ST
Mailing Address - Street 2:PH 15 WEST - 1564
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3725
Mailing Address - Country:US
Mailing Address - Phone:212-305-7399
Mailing Address - Fax:
Practice Address - Street 1:630 W 168TH ST
Practice Address - Street 2:PH 15 WEST - 1564
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3725
Practice Address - Country:US
Practice Address - Phone:212-305-7399
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-03
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
LF8291Medicare PIN