# BIMC FACULTY PRACTICE

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

## Provider details

- **NPI number:** 1902099351
- **Authorized official:** DEBORAH HACKETT (AVP)
- **Authorized official phone:** (212) 256-3424

## Contact information

- **Practice address:** 10 UNION SQ E, SUITE 5B, NEW YORK, NY 10003-3314
- **Practice address phone:** (212) 844-8767
- **Mailing address:** 10 UNION SQ E, SUITE 5B, NEW YORK, NY 10003-3314
- **Mailing address phone:** (212) 844-8767

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | — |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | NULL | Yes |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | — | Yes |
| 207Y00000X | Otolaryngology Physician | — | NULL | — |
| 207Y00000X | Otolaryngology Physician | — | — | — |

## Other

- **Enumeration date:** 08/20/2007
- **Last updated:** 02/02/2012