Healthcare Provider Details

I. General information

NPI: 1538375845
Provider Name (Legal Business Name): BIMC FACULTY PRACTICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1ST AVENUE & 16TH STREET DEPARTMENT OF RADIOLOGY
NEW YORK NY
10003-4901
US

IV. Provider business mailing address

1780 BROADWAY STE 1100
NEW YORK NY
10019-1414
US

V. Phone/Fax

Practice location:
  • Phone: 212-590-2922
  • Fax: 212-590-2977
Mailing address:
  • Phone: 212-590-2922
  • Fax: 212-590-2977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085D0003X
TaxonomyDiagnostic Neuroimaging (Radiology) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL ABIRI
Title or Position: CHAIRMAN
Credential: MD
Phone: 212-590-2922