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, SUITE 2Q, NEW YORK, NY 10003-3314
(212) 844-8888
(212) 844-6437
Mailing address
PO BOX 95000-2445, PHILADELPHIA, PA 19195-2445
(212) 844-6890
(212) 844-6437
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
—
—
2084N0600X
Clinical Neurophysiology Physician
—
—
Other
Enumeration date
01/18/2007
Last updated
02/03/2012
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