Healthcare Provider Details

I. General information

NPI: 1700887411
Provider Name (Legal Business Name): MEMORIAL HOSPITAL FOR CANCER AND ALLIED DISEASES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2005
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1275 YORK AVE
NEW YORK NY
10065-6007
US

IV. Provider business mailing address

1275 YORK AVE
NEW YORK NY
10065-6007
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number7002020H
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number003945
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number021404
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number024335
License Number StateNY

VIII. Authorized Official

Name: KATHRYN MARTIN
Title or Position: COO
Credential:
Phone: 212-639-2623