Healthcare Provider Details

I. General information

NPI: 1265483846
Provider Name (Legal Business Name): LEE OKUROWSKI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 GLEASON ST
HYANNIS MA
02601-5223
US

IV. Provider business mailing address

26 GLEASON ST
HYANNIS MA
02601-5223
US

V. Phone/Fax

Practice location:
  • Phone: 508-771-1800
  • Fax: 508-771-6445
Mailing address:
  • Phone: 508-771-1800
  • Fax: 508-771-6445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number208066
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: