Healthcare Provider Details

I. General information

NPI: 1114221843
Provider Name (Legal Business Name): MEMORIAL SLOAN KETTERING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2011
Last Update Date: 01/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 E 60TH ST APT. 28E
NEW YORK NY
10022-1514
US

IV. Provider business mailing address

303 E 60TH ST APT. 28E
NEW YORK NY
10022-1514
US

V. Phone/Fax

Practice location:
  • Phone: 646-588-9695
  • Fax:
Mailing address:
  • Phone: 646-588-9695
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code281P00000X
TaxonomyChronic Disease Hospital
License NumberP76622
License Number StateNY

VIII. Authorized Official

Name: DR. DEIRDRE M JONES
Title or Position: MD
Credential: MD
Phone: 646-588-9695