Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0204X | Pediatric Emergency Doctor | MT186930 | PA |
NPI | 1245274976 |
---|---|
Provider Name | Dr. Jannet Jieyun Lee-Jayaram |
First Address | Lawrenceville, NJ 08648-2875 |
Second Address | Philadelphia, PA 19134 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2006 |
Last Update Date | 08/07/2007 |