NPIMap

Organization Active NPI

Memorial Sloan Kettering Cancer Center

  • Community/Retail Pharmacy
  • Montvale, NJ
National Provider Identifier
1669963880
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
28RS00763100 Issued in NJ
Legal business name
MEMORIAL SLOAN KETTERING CANCER CENTER
Practice address
225 Summit Ave Ste 1001
Montvale, NJ 07645-1523
Phone
(201) 775-7055
NPI assigned
May 23, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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

Authorized official

Name
Susan Murillo
Title
Pharmacy Manager
Phone
(212) 639-2206

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 28RS00763100 NJ Primary

Addresses

Primary practice location

225 Summit Ave Ste 1001
Montvale, NJ 07645-1523

Mailing address

1275 York Ave RM H-313
New York, NY 10065-6007
Phone (212) 639-2206

Other names 1

  • Memorial Sloan Kettering at Bergen Retail Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191104000276 NJ DME Supplier - Pharmacy 9931304375 Practice locations: Montvale, NJ

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Mem Sloan Kettering Cancer Ctr225 Summit Ave, Montvale, NJ 07645-1523(201) 775-7055 Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Jun 1, 1999

National Provider Directory

National Provider Directory
Tax ID family
Memorial Sloan Kettering Cancer Center21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

Organizations that report the same tax identification number in the National Provider Directory.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1527033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710806400000",
    "number": "1669963880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 YORK AVE RM H-313",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656007",
            "telephone_number": "212-639-2206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 SUMMIT AVE STE 1001",
            "city": "MONTVALE",
            "state": "NJ",
            "postal_code": "076451523",
            "telephone_number": "201-775-7055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL SLOAN KETTERING CANCER CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-23",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A",
        "authorized_official_last_name": "MURILLO",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "212-639-2206"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NJ",
            "license": "28RS00763100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial Sloan Kettering at Bergen Retail",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Montvale, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.