Basic Information
| Provider Information | |||||||||
| NPI: | 1013365733 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MEMORIAL SLOAN KETTERING CANCER CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1575 HARBOR BLVD | ||||||||
| Address2: | APT 3514 | ||||||||
| City: | WEEHAWKEN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 070866894 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9179742412 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1275 YORK AVE | ||||||||
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| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100656007 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2126392000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/03/2016 | ||||||||
| LastUpdateDate: | 06/03/2016 | ||||||||
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| AuthorizedOfficialLastName: | HINE | ||||||||
| AuthorizedOfficialFirstName: | MARISA | ||||||||
| AuthorizedOfficialMiddleName: | JEAN | ||||||||
| AuthorizedOfficialTitleorPosition: | NURSE PRACTITIONER | ||||||||
| AuthorizedOfficialTelephone: | 9179742412 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | NP | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 284300000X | Y | Hospitals | Special Hospital |
No ID Information.