# BIMC FACULTY PRACTICE

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

## Provider details

- **NPI number:** 1790093342
- **Authorized official:** DEBORAH HACKETT (VP)
- **Authorized official phone:** (212) 256-3424

## Contact information

- **Practice address:** 10 UNION SQ E, NEW YORK, NY 10003-3314
- **Practice address phone:** (212) 420-2704
- **Mailing address:** 160 WATER ST, 23RD FL, NEW YORK, NY 10038-4922
- **Mailing address phone:** (212) 420-2704

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 2084P0800X | Psychiatry Physician | — | NULL | — |
| 2084P0800X | Psychiatry Physician | — | — | — |

## Other

- **Enumeration date:** 09/16/2010
- **Last updated:** 09/16/2010