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Organization

BIMC FACULTY PRACTICE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DEBORAH HACKETT (AVP)
(646) 605-8365
Entity
Organization

Contact information

Practice address
55 E 34TH ST, NEW YORK, NY 10016-4337
(212) 252-6131
Mailing address
150 EAST 42ND STREET, MANAGED CARE 5TH FL, NEW YORK, NY 10017-4922
(646) 605-4155

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
207Q00000X
Family Medicine Physician
207R00000X
Internal Medicine Physician
Primary
207RC0000X
Cardiovascular Disease Physician
207RG0100X
Gastroenterology Physician
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
207RP1001X
Pulmonary Disease Physician
207W00000X
Ophthalmology Physician
207X00000X
Orthopaedic Surgery Physician
207Y00000X
Otolaryngology Physician
208600000X
Surgery Physician
208800000X
Urology Physician

Other

Enumeration date
06/05/2007
Last updated
12/14/2015
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