Organization
BIMC FACULTY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH HACKETT (VP)
(212) 256-3424
Entity
Organization
Contact information
Practice address
10 UNION SQ E, SUITE 5B, NEW YORK, NY 10003-3314
(212) 844-6852
Mailing address
160 WATER ST, 20TH FLOOR, NEW YORK, NY 10038-4922
(212) 844-6852
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
03/30/2012
Last updated
03/30/2012
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