Healthcare Provider Details
I. General information
NPI: 1831582048
Provider Name (Legal Business Name): ROBERT LEE MD P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/12/2015
Last Update Date: 03/01/2020
Certification Date: 03/01/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3495 BAILEY AVE
BUFFALO NY
14215-1129
US
IV. Provider business mailing address
266 ELMWOOD AVE # 178
BUFFALO NY
14222-2202
US
V. Phone/Fax
- Phone: 716-834-9200
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207LP2900X |
| Taxonomy | Pain Medicine (Anesthesiology) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ROBERT
EDWARD
LEE
Title or Position: CEO
Credential: MD
Phone: 716-834-9200