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
126 W 60TH ST, NEW YORK, NY 10023-7402
(212) 636-3970
Mailing address
126 W 60TH ST, NEW YORK, NY 10023-7402
(212) 636-3970
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
Primary
—
—
2086S0120X
Pediatric Surgery Physician
—
—
Other
Enumeration date
11/10/2011
Last updated
11/10/2011
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