Organization
RALPH LAUREN CENTER FOR CANCER CARE AND PREVENTION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MILLIE BENITEZ (REVENUE CYCLE MANAGER)
(212) 987-1777
Entity
Organization
Contact information
Practice address
1919 MADISON AVE, NEW YORK, NY 10035-2745
(212) 987-1777
(212) 987-1776
Mailing address
1919 MADISON AVE, NEW YORK, NY 10035-2745
(212) 987-1777
(212) 987-1776
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
7002172R
NY
261QM1300X
Multi-Specialty Clinic/Center
Primary
7002172R
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02424633
—
NY
Enumeration date
12/28/2005
Last updated
11/17/2017
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