# RALPH LAUREN CENTER FOR CANCER CARE AND PREVENTION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861479248
- **Authorized official:** MILLIE BENITEZ (REVENUE CYCLE MANAGER)
- **Authorized official phone:** (212) 987-1777

## Contact information

- **Practice address:** 1919 MADISON AVE, NEW YORK, NY 10035-2745
- **Practice address phone:** (212) 987-1777
- **Practice address fax:** (212) 987-1776
- **Mailing address:** 1919 MADISON AVE, NEW YORK, NY 10035-2745
- **Mailing address phone:** (212) 987-1777
- **Mailing address fax:** (212) 987-1776

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | 7002172R | NY | — |
| 261QM1300X | Multi-Specialty Clinic/Center | 7002172R | NY | Yes |

## Other

- **Enumeration date:** 12/28/2005
- **Last updated:** 11/17/2017