Healthcare Provider Details

I. General information

NPI: 1669810313
Provider Name (Legal Business Name): LINDA MARIE MCKENNA ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2013
Last Update Date: 04/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MEMORIAL SLOAN KETTERING CANCER CENTER 1275 YORK AVENUE M7 ROOM 748
NEW YORK NY
10065
US

IV. Provider business mailing address

MEMORIAL SLOAN KETTERING CANCER CENTER 1275 YORK AVENUE M7 ROOM 748
NEW YORK NY
10065
US

V. Phone/Fax

Practice location:
  • Phone: 212-639-7227
  • Fax: 212-639-4030
Mailing address:
  • Phone: 212-639-7227
  • Fax: 212-639-4030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number306023
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: