Organization
LONG ISLAND COLLEGE HOSPITAL
Active
Other names
LICH PLASTIC AND RECONSTRUCTION
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH HACKETT VP (MANAGING EMPLOYEE)
(212) 256-3421
Entity
Organization
Contact information
Practice address
185 MONTAGUE STREET, BROOKLYN, NY 11201
(212) 256-3682
Mailing address
160 WATER STREET, 20FL, NEW YORK, NY 10038
(212) 256-3682
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
—
—
Other
Enumeration date
08/03/2006
Last updated
11/05/2009
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