# TRUSTEES OF COLUMBIA UNIVERSITY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Harlem Faculty Practice - Oral
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952544033
- **Authorized official:** MS. SUDHA PENTYALA (DIRECTOR)
- **Authorized official phone:** (718) 579-6021

## Contact information

- **Practice address:** 506 LENOX AVE, WP BUILDING, 7TH FLOOR, ROOM 742, NEW YORK, NY 10037-1802
- **Practice address phone:** (212) 939-3501
- **Mailing address:** 506 LENOX AVENUE, WP BUILDING, 7TH FLOOR, ROOM 742, NEW YORK, NY 10037-1889
- **Mailing address phone:** (212) 939-3501

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 04/20/2009
- **Last updated:** 04/20/2009