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Organization
BIMC FACULTY PRACTICE
Active
Organization
BIMC FACULTY PRACTICE
Active
Other names
COMMUNITY PRIMARY CARE
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH HACKETT (VP)
(212) 256-3424
Entity
Organization
Contact information
Practice address
1825 PARK AVE, NEW YORK, NY 10035-1641
(212) 774-3254
Mailing address
160 WATER ST, 20TH FL, NEW YORK, NY 10038-4922
(212) 774-3254
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
—
NULL
207K00000X
Allergy & Immunology Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
2084P0802X
Addiction Psychiatry Physician
—
NULL
2084P0802X
Addiction Psychiatry Physician
—
—
Other
Enumeration date
04/06/2011
Last updated
04/06/2011
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