Provider Demographics
NPI:1154436855
Name:COLUMBIA UNIVERSITY HEALTH CARE, INC.
Entity type:Organization
Organization Name:COLUMBIA UNIVERSITY HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR ASSOC DEAN OF CLINICAL SERV
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:ERRANTE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:212-342-3832
Mailing Address - Street 1:630 W 168TH ST
Mailing Address - Street 2:P&S BOX 20
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3725
Mailing Address - Country:US
Mailing Address - Phone:212-342-3832
Mailing Address - Fax:212-305-2964
Practice Address - Street 1:622 W 168TH ST
Practice Address - Street 2:P&S BOX 20
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3720
Practice Address - Country:US
Practice Address - Phone:212-342-3832
Practice Address - Fax:212-305-2964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2017-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY261Q00000X, 261QD0000X, 261QS0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QS0112XAmbulatory Health Care FacilitiesClinic/CenterOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01757051Medicaid
NYW40002Medicare PIN
NYW40001Medicare PIN
NYW40003Medicare PIN