Organization
BIMC FACULTY PRACTICE
Active
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
3555 BAINBRIDGE AVE, BRONX, NY 10467-1411
(718) 655-2400
Mailing address
160 WATER ST, 20TH FLOOR, NEW YORK, NY 10038-4922
(212) 299-5718
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
—
—
Other
Enumeration date
09/29/2010
Last updated
09/29/2010
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