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) 523-6745
Mailing address
160 WATER ST, 20TH FLOOR, NEW YORK, NY 10038-4922
(212) 256-3539
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
207P00000X
Emergency Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
2084P0800X
Psychiatry Physician
—
—
363A00000X
Physician Assistant
—
—
Other
Enumeration date
08/16/2007
Last updated
09/26/2012
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