Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 052108 | CT |
Y | 208600000X | Surgeon | 052108 | CT |
N | 2086S0102X | Surgical Critical Care | 052108 | CT |
NPI | 1104026392 |
---|---|
Provider Name | Dr. Jessica M Lee |
First Address | Hartford, CT 06106 |
Second Address | Hartford, CT 06106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2007 |
Last Update Date | 15/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
16011719-1A | UCONN ID (01) | CT |