Provider Demographics
NPI:1073640744
Name:MEMORIAL SLOAN KETTERING CANCER CENTER
Entity Type:Organization
Organization Name:MEMORIAL SLOAN KETTERING CANCER CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ATTENDING
Authorized Official - Prefix:MR
Authorized Official - First Name:JOACHIM
Authorized Official - Middle Name:
Authorized Official - Last Name:YAHALOM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-639-5999
Mailing Address - Street 1:351 E 51ST ST
Mailing Address - Street 2:APARTMENT 14C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-6702
Mailing Address - Country:US
Mailing Address - Phone:212-486-0121
Mailing Address - Fax:212-639-8876
Practice Address - Street 1:1275 YORK AVE
Practice Address - Street 2:DEPT. OF RADIATION ONCOLOGY, SM03
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-6007
Practice Address - Country:US
Practice Address - Phone:212-639-5999
Practice Address - Fax:212-639-8876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY167759-1284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYE53693Medicare UPIN