MEDICARE: MEMORIAL SLOAN KETTERING CANCER CENTER

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
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	021404	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2061173	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588606875
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEMORIAL SLOAN KETTERING CANCER CENTER

Provider Business Mailing Address
First Line	:	1275 YORK AVE RM H-313
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10065-6007
Country	:	US
Telephone Number	:	212-639-2206
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 E 66TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10065-6800
Country	:	US
Telephone Number	:	646-888-0732
Fax Number	:	646-888-5401

Authorized Official
Title or Position	:	PHARMACY MANAGER
Name	:	SUSAN MURILLO
Credential	:
Telephone Number	:	212-639-2206

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	03/17/2025

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Directions to “MEMORIAL SLOAN KETTERING CANCER CENTER ” Practice Location

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