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General NPI Number Information
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NPI Number | 1124378278
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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 | 09/17/2012
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Last Update Date | 09/17/2012
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Provider Practice Location Address
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Address Line | 1275 YORK AVE
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City | NEW YORK
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State | NY
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Zip | 10065-6007
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Country | US
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Telephone | 908-930-6670
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Fax |
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Provider Business Mailing Address
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Address Line | 26 ELM ST
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-2339
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Country | US
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Telephone | 908-930-6670
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | DINA BOULOS
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Credential | PHARMD
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Telephone | 908-930-6670
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336I0012X
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Taxonomy Name | Institutional Pharmacy
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License Number | 055828
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License Number State | NY
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