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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