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General NPI Number Information
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NPI Number | 1023268018
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Entity Type | Organization
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Legal Business Name | IRENE M LEE MD PC
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Dates
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Enumeration Date | 09/25/2008
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Last Update Date | 08/25/2011
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Provider Practice Location Address
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Address Line | 903 PROVIDENCE PL APARTMENT 362
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City | PROVIDENCE
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State | RI
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Zip | 02903-7000
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Country | US
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Telephone | 646-863-2049
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Fax |
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Provider Business Mailing Address
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Address Line | 903 PROVIDENCE PL APARTMENT 362
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City | PROVIDENCE
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State | RI
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Zip | 02903-7000
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. IRENE LEE
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Credential | M.D.
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Telephone | 646-863-2049
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 248545
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License Number State | NY
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