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General NPI Number Information
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NPI Number | 1508046764
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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 | 11/05/2007
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Last Update Date | 11/05/2007
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Provider Practice Location Address
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Address Line | 1275 YORK AVE M1443
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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 | 212-639-6946
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Fax |
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Provider Business Mailing Address
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Address Line | 1275 YORK AVE M1443
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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 | 212-639-6946
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MRS. AMY ROSE DEVIGNE
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Credential | NP
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Telephone | 212-639-6946
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 332888
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License Number State | NY
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