Healthcare Provider Details

I. General information

NPI: 1134306855
Provider Name (Legal Business Name): MEMORIAL SLOAN KETTERING CANCER CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2008
Last Update Date: 01/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1275 YORK AVE MEMORIAL 7
NEW YORK NY
10065-6007
US

IV. Provider business mailing address

1275 YORK AVE MEMORIAL 7
NEW YORK NY
10065-6007
US

V. Phone/Fax

Practice location:
  • Phone: 212-639-2000
  • Fax: 212-639-4030
Mailing address:
  • Phone: 212-639-2000
  • Fax: 212-639-4030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License NumberF-304623-1
License Number StateNY

VIII. Authorized Official

Name: ELIZABETH ANN KELLIHER
Title or Position: NURSE PRACTITIONER
Credential: NP
Phone: 212-639-6920