Organization
SLRHC FACULTY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH HACKETT (VP)
(212) 256-3424
Entity
Organization
Contact information
Practice address
1000 10TH AVE, NEW YORK, NY 10019-1147
(212) 523-2211
Mailing address
160 WATER ST, 20TH FLOOR, NEW YORK, NY 10038-4922
(212) 256-3539
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
2086S0129X
Vascular Surgery Physician
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
Other
Enumeration date
06/05/2007
Last updated
02/02/2012
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