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General NPI Number Information
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NPI Number | 1073640744
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Entity Type | Organization
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Legal Business Name | MEMORIAL SLOAN KETTERING CANCER CENTER
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1275 YORK AVE DEPT. OF RADIATION ONCOLOGY, SM03
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City | NEW YORK
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State | NY
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Zip | 10021-6007
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Country | US
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Telephone | 212-639-5999
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Fax | 212-639-8876
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Provider Business Mailing Address
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Address Line | 351 E 51ST ST APARTMENT 14C
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City | NEW YORK
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State | NY
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Zip | 10022-6702
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Country | US
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Telephone | 212-486-0121
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Fax | 212-639-8876
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Authorized Official
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Title or Position | ATTENDING
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Name | MR. JOACHIM YAHALOM
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Credential | M.D.
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Telephone | 212-639-5999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 284300000X
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Taxonomy Name | Special Hospital
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License Number | 167759-1
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License Number State | NY
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