Healthcare Provider Details

I. General information

NPI: 1275258048
Provider Name (Legal Business Name): MEMORIAL MEDICAL CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2022
Last Update Date: 10/12/2022
Certification Date: 10/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2236 NOSTRAND AVE
BROOKLYN NY
11210
US

IV. Provider business mailing address

633 3RD AVE MSKCC-PBD/ 4TH FL
NEW YORK NY
10017
US

V. Phone/Fax

Practice location:
  • Phone: 212-639-2000
  • Fax:
Mailing address:
  • Phone: 646-227-3813
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL P HARRINGTON
Title or Position: EXEC VP & CHIEF FINANCIAL OFFICER
Credential:
Phone: 646-227-3722