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NPI Code Detail

MEDICARE: MS. CAROLE LEE R.D.

MEDICARE:  MS. CAROLE  LEE  R.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered DietitianDN000692PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10003240801OTHERPABLUE CROSS PROVIDER NUMBE
271000285OTHERPAUNITED HEALTHCARE PROV NU

General Provider Information

NPI Number : 1093771370
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CAROLE LEE R.D.
Provider Business Mailing Address
First Line : 3200 READING CREST AVE
Second Line :
City : READING
State : PA
Zip : 19605-1656
Country : US
Telephone Number : 610-921-2366
Fax Number : 610-929-5138
Provider Business Practice Location Address
First Line : 3200 READING CREST AVE
Second Line :
City : READING
State : PA
Zip : 19605-1656
Country : US
Telephone Number : 610-921-2366
Fax Number : 610-929-5138
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2006
Last Update Date : 07/08/2007

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Directions to “ MS. CAROLE LEE R.D.” Practice Location

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