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General NPI Number Information
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NPI Number | 1306096508
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Entity Type | Organization
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Legal Business Name | MSKCC CLINICAL PRACTICE PLAN
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Dates
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Enumeration Date | 09/24/2008
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Last Update Date | 09/24/2008
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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 | 212-639-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 633 3RD AVE
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City | NEW YORK
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State | NY
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Zip | 10017-6706
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ASSOCIATE DIRECTOR
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Name | SALVATORE M ANDREOZZI
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Credential |
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Telephone | 646-227-3751
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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