Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | MD066476L | PA |
NPI | 1013944073 |
---|---|
Provider Name | Dr. Sonya Lee |
First Address | Phila, PA 19104-2640 |
Second Address | Phila, PA 19104-2640 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2006 |
Last Update Date | 03/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
018173 | (05) | PA |
H23911 | (02) | PA |