Organization
TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK
Active
Other names
Columbia Endovascular Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VIRTUDES REYES (CREDENTIALING COORDINATOR)
(212) 305-6912
Entity
Organization
Contact information
Practice address
51 WEST 51ST STREET STE 301, NEW YORK, NY 10019
(212) 305-5123
(212) 305-8636
Mailing address
630 W 168TH ST # 28, NEW YORK, NY 10032-3720
(212) 305-1948
(212) 305-5777
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02186161
—
NY
01
—
1467484394
GROUP MEMBER NPI#
NY
01
—
1639102569
GROUP MEMBER NPI#
NY
Enumeration date
08/31/2006
Last updated
03/04/2016
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