NPIMap

Organization Active NPI

Memorial Sloan-Kettering Cancer Center Suffolk at Hauppauge

  • Dermatology Physician
  • Hauppauge, NY
National Provider Identifier
1669443123
Registry record updated Jun 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
MEMORIAL SLOAN-KETTERING CANCER CENTER SUFFOLK AT HAUPPAUGE
Practice address
800 Veterans Memorial Hwy
Hauppauge, NY 11788-2948
Phone
(212) 639-2000
NPI assigned
Jan 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Salvatore M Andreozzi
Title
Associate Director
Phone
(646) 227-3751

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X Primary
MOHS-Micrographic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ND0101X

Addresses

Primary practice location

800 Veterans Memorial Hwy
Hauppauge, NY 11788-2948

Mailing address

633 3Rd Ave
Box 3
New York, NY 10017-6706

Other names 1

  • MSKCC Suffolk @ Hauppauge Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040323001384 NY Part B Supplier - Clinic/Group Practice 1951292408 Receives reassigned benefits from 10 practitioners
Practice locations: Hauppauge, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1669443123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 3RD AVE",
            "address_2": "BOX 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100176706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 VETERANS MEMORIAL HWY",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117882948",
            "telephone_number": "212-639-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL SLOAN-KETTERING CANCER CENTER SUFFOLK AT HAUPPAUGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-31",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "ANDREOZZI",
        "authorized_official_first_name": "SALVATORE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ASSOCIATE DIRECTOR",
        "authorized_official_telephone_number": "646-227-3751"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MSKCC Suffolk @ Hauppauge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hauppauge, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.