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Organization
LONG ISLAND COLLEGE HOSPITAL
Active
Organization
LONG ISLAND COLLEGE HOSPITAL
Active
Other names
LICH PLASTIC AND RECONSTRUCTION
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH HACKETT VP (MANAGING EMPLOYEE)
(212) 256-3421
Entity
Organization
Contact information
Practice address
185 MONTAGUE STREET, BROOKLYN, NY 11201
(212) 256-3682
Mailing address
160 WATER STREET, 20FL, NEW YORK, NY 10038
(212) 256-3682
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
—
NULL
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
—
—
Other
Enumeration date
08/03/2006
Last updated
11/05/2009
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