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NPI Code Detail

MEDICARE: BIMC FACULTY PRACTICE

MEDICARE: BIMC FACULTY PRACTICE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207XS0114XAdult Reconstructive Orthopaedic Surgery Physician
2207X00000XOrthopaedic Surgery Physician

General Provider Information

NPI Number : 1356650071
Entity Type Code : Organization
Provider Name (Legal Business Name) : BIMC FACULTY PRACTICE
Provider Business Mailing Address
First Line : 160 WATER ST
Second Line : 20TH FLOOR
City : NEW YORK
State : NY
Zip : 10038-4922
Country : US
Telephone Number : 212-299-5718
Fax Number :
Provider Business Practice Location Address
First Line : 3555 BAINBRIDGE AVE
Second Line :
City : BRONX
State : NY
Zip : 10467-1411
Country : US
Telephone Number : 718-655-2400
Fax Number :
Authorized Official
Title or Position : VP
Name : DEBORAH HACKETT
Credential :
Telephone Number : 212-256-3424
Provider Enumeration Date : 09/29/2010
Last Update Date : 09/29/2010

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Directions to “BIMC FACULTY PRACTICE ” Practice Location

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