Provider Demographics
NPI:1538323910
Name:BIMC FACULTY PRACTICE
Entity Type:Organization
Organization Name:BIMC FACULTY PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AVP
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:HACKETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-256-3424
Mailing Address - Street 1:160 WATER ST
Mailing Address - Street 2:20TH FL
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-4922
Mailing Address - Country:US
Mailing Address - Phone:212-256-3539
Mailing Address - Fax:
Practice Address - Street 1:9 NATHAN D PERLMAN PL
Practice Address - Street 2:6TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3801
Practice Address - Country:US
Practice Address - Phone:212-420-4714
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-15
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty