Basic Information
Provider Information
NPI: 1619386406
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CONNELL
FirstName: LOUISE CATHERINE
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MB BCH BAO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1275 YORK AVE
Address2: MEMORIAL SLOAN KETTERING CANCER CENTER
City: NEW YORK
State: NY
PostalCode: 100656007
CountryCode: US
TelephoneNumber: 2126392000
FaxNumber:  
Practice Location
Address1: 1275 YORK AVE
Address2: MEMORIAL SLOAN KETTERING CANCER CENTER
City: NEW YORK
State: NY
PostalCode: 10065
CountryCode: US
TelephoneNumber: 2126392000
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/06/2014
LastUpdateDate: 01/22/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RX0202X295865NYY Allopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology

No ID Information.


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