Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 057598-1 | NY |
NPI | 1144569021 |
---|---|
Provider Name | Claire J Lee |
First Address | New York, NY 10019-5751 |
Second Address | Davie, FL 33314-1897 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2013 |
Last Update Date | 17/10/2017 |