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Organization
SLRHC FACULTY PRACTICE
Active
Organization
SLRHC FACULTY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH HACKETT (VP)
(212) 256-3424
Entity
Organization
Contact information
Practice address
1111 AMSTERDAM AVE, NEW YORK, NY 10025-1716
(212) 523-1876
Mailing address
555 W 57TH ST, NEW YORK, NY 10019-2925
(212) 523-1876
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
2084N0400X
Neurology Physician
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
10/10/2012
Last updated
10/10/2012
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