Organization
TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK
Active
Organization
TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK
Active
Other names
Department of Dermatology
Organization subpart
No
Provider details
NPI number
Authorized official
MARK MCDOUGLE (SVP/CHIEF OPERATING OFFICER)
(212) 305-6607
Entity
Organization
Contact information
Practice address
630 W 168TH ST, VC15-207, NEW YORK, NY 10032-3725
(212) 305-2155
(212) 927-9704
Mailing address
630 W 168TH ST, VC15-207, NEW YORK, NY 10032-3725
(212) 305-2155
(212) 927-9704
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
207ND0900X
Dermatopathology Physician
—
—
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
—
—
207NP0225X
Pediatric Dermatology Physician
—
—
Other
Enumeration date
09/22/2006
Last updated
02/05/2015
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