Organization
BIMC FACULTY PRACTICE
Active
Organization
BIMC FACULTY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH HACKETT (AVP)
(212) 256-3424
Entity
Organization
Contact information
Practice address
10 UNION SQ E, NEW YORK, NY 10003-3314
(212) 844-8690
Mailing address
160 WATER ST, 20TH FL, NEW YORK, NY 10038-4922
(212) 256-3539
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
—
—
Other
Enumeration date
08/07/2007
Last updated
07/15/2010
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