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Organization

SLRHC FACULTY PRACTICE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DEBORAH HACKETT (PROVIDER ENROLLMENT MANAGER)
(212) 256-3424
Entity
Organization

Contact information

Practice address
1111 AMSTERDAM AVE, NEW YORK, NY 10025-1716
(212) 523-5419
Mailing address
160 WATER ST, 20TH FLOOR, NEW YORK, NY 10038-4922
(212) 256-3539

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary

Other

Enumeration date
06/05/2007
Last updated
02/03/2012
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