Provider Demographics
NPI:1962677203
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:NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:A
Authorized Official - Last Name:O'CONNOR
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:212-639-8194
Mailing Address - Street 1:425 E 67TH ST
Mailing Address - Street 2:DEPT. OF RADIATION ONCOLOGY
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-6004
Mailing Address - Country:US
Mailing Address - Phone:212-639-8194
Mailing Address - Fax:646-422-2265
Practice Address - Street 1:425 E 67TH ST
Practice Address - Street 2:DEPT. OF RADIATION ONCOLOGY
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-6004
Practice Address - Country:US
Practice Address - Phone:212-639-8194
Practice Address - Fax:646-422-2265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF303228-1282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital