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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
10 UNION SQ E, NEW YORK, NY 10003-3314
(212) 256-3539
Mailing address
160 WATER ST, 20TH FLOOR, NEW YORK, NY 10038-4922
(212) 256-3539

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
207R00000X
Internal Medicine Physician
Primary
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
207RG0100X
Gastroenterology Physician
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
207RI0200X
Infectious Disease Physician
207RN0300X
Nephrology Physician
207RP1001X
Pulmonary Disease Physician
207RR0500X
Rheumatology Physician
208D00000X
General Practice Physician

Other

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