# SLRHC FACULTY PRACTICE

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

## Provider details

- **NPI number:** 1578765954
- **Authorized official:** DEBORAH HACKETT (PROVIDER ENROLLMENT MANAGER)
- **Authorized official phone:** (212) 256-3424

## Contact information

- **Practice address:** 1111 AMSTERDAM AVE, NEW YORK, NY 10025-1716
- **Practice address phone:** (212) 523-5419
- **Mailing address:** 160 WATER ST, 20TH FLOOR, NEW YORK, NY 10038-4922
- **Mailing address phone:** (212) 256-3539

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RH0003X | Hematology & Oncology Physician | — | NULL | Yes |
| 207RH0003X | Hematology & Oncology Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/05/2007
- **Last updated:** 02/03/2012