Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0214X | Pediatric Pulmonologist | 218995 | NY |
Y | 2080P0214X | Pediatric Pulmonologist | 25MA08071400 | NJ |
NPI | 1134102858 |
---|---|
Provider Name | Dr. Ada Lee |
First Address | Hackensack, NJ 07601-1914 |
Second Address | Hackensack, NJ 07601-1914 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2005 |
Last Update Date | 09/05/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02598965 | (05) | NY |
I29125 | (02) | NY |