# TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Columbia Presbyterian Neuro-Interventional Radiology
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720196090
- **Authorized official:** VIRTUDES REYES CREDENTIALING COORDI (CREDENTIALING COORDINATOR)
- **Authorized official phone:** (212) 305-6912

## Contact information

- **Practice address:** 622 WEST 168TH STREET, MHB-8 SO. KNUCKLE, NEW YORK, NY 10032
- **Practice address phone:** (212) 305-6384
- **Practice address fax:** (212) 305-5476
- **Mailing address:** 630 WEST 168TH STREET MC28, NEW YORK, NY 10032-3725
- **Mailing address phone:** (212) 305-1948
- **Mailing address fax:** (212) 305-5777

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2085N0700X | Neuroradiology Physician | NXA | NY | Yes |
| 2085N0700X | Neuroradiology Physician | — | NULL | — |
| 2085N0700X | Neuroradiology Physician | — | — | — |

## Other

- **Enumeration date:** 08/28/2006
- **Last updated:** 03/13/2015