Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 0102202577 | VA |
Y | 111NI0900X | Internist | 0102202577 | VA |
N | 207R00000X | Internist | 236291 | NY |
N | 111NI0900X | Internist | 236291 | NY |
N | 207R00000X | Internist | OS014484 | PA |
N | 111NI0900X | Internist | OS014484 | PA |
NPI | 1003805243 |
---|---|
Provider Name | Dr. Sanghee Rose Lee |
First Address | Philadelphia, PA 19140-5220 |
Second Address | Philadelphia, PA 19140-5103 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2005 |
Last Update Date | 23/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1003805243 | NPI NUMBER (01) | NY |
1022631010001 | (05) | PA |
1022631010002 | (05) | PA |
1821048612 | GROUP NPI NUMBER (01) | NY |
2093179 | HIGHMARK BLUE SHIELD (01) | PA |
I43177 | (02) | NY |