# BIMC FACULTY PRACTICE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023314978
- **Authorized official:** DEBORAH HACKETT (VP)
- **Authorized official phone:** (212) 256-3424

## Contact information

- **Practice address:** 54 SOUTH DEAN STREET, ENGLEWOOD, NJ 07631
- **Practice address phone:** (212) 844-6940
- **Mailing address:** 160 WATER ST, 20TH FLOOR, NEW YORK, NY 10038-4922
- **Mailing address phone:** (212) 844-6940

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | — | NULL | — |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | — | — | — |

## Other

- **Enumeration date:** 02/09/2011
- **Last updated:** 02/17/2011