Healthcare Provider Details

I. General information

NPI: 1992952279
Provider Name (Legal Business Name): SONJA EUGENIA LEE LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2008
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

68 ASHLEY ST
BUFFALO NY
14212-1734
US

IV. Provider business mailing address

68 ASHLEY ST
BUFFALO NY
14212-1734
US

V. Phone/Fax

Practice location:
  • Phone: 716-228-2389
  • Fax:
Mailing address:
  • Phone: 717-228-2389
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number092132-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: