# BIMC FACULTY PRACTICE

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

## Provider details

- **NPI number:** 1275736688
- **Authorized official:** LUCIA GONZALEZ (PROVIDER ENROLLMENT MANAGER)
- **Authorized official phone:** (646) 605-4155

## Contact information

- **Practice address:** 10 UNION SQ E, SUITE 3B, NEW YORK, NY 10003-3314
- **Practice address phone:** (212) 844-8220
- **Mailing address:** 150 E 42ND ST, 5TH FLOOR, NEW YORK, NY 10017-5612
- **Mailing address phone:** (646) 605-4155

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/06/2007
- **Last updated:** 12/04/2015