Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | 225323 | MA |
NPI | 1508937269 |
---|---|
Provider Name | Grace Lee |
First Address | Boston, MA 02109-4806 |
Second Address | Boston, MA 02215-3904 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 15/06/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0035994 | NEIGHBORHOOD HEALTH PLAN (01) | MA |
0991522 | CIGNA (01) | MA |
2106469 | (05) | MA |
470422 | TUFTS HEALTH PLAN (01) | MA |
AA39640 | HARVARD PILGRIM (01) | MA |
E91624 | (02) | MA |
J29084 | BLUE CROSS (01) | MA |