Organization
BIMC FACULTY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUCIA GONZALEZ (PROVIDER ENROLLMENT MANAGER)
(646) 605-4155
Entity
Organization
Contact information
Practice address
10 UNION SQ E, SUITE 4 K, NEW YORK, NY 10003-3314
(212) 844-8930
Mailing address
150 E 42ND ST, 5TH FLOOR, NEW YORK, NY 10017-5612
(646) 605-4155
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
—
—
Other
Enumeration date
06/06/2007
Last updated
01/22/2016
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