Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 150146 | NY |
NPI | 1285617365 |
---|---|
Provider Name | Dr. April Lee |
First Address | Staten Island, NY 10305-4900 |
Second Address | Staten Island, NY 10305-3408 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2005 |
Last Update Date | 07/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01075341 | (05) | NY |
C06998 | (02) | NM |