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General NPI Number Information
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NPI Number | 1093786733
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Entity Type | Individual
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Provider Name | MARVIN S. LEE M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/31/2006
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Last Update Date | 09/14/2011
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Provider Practice Location Address
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Address Line | 176 DENISON PKWY E
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City | CORNING
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State | NY
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Zip | 14830-2814
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Country | US
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Telephone | 607-937-7278
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Fax | 607-937-7860
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Provider Business Mailing Address
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Address Line | 1 GUTHRIE SQ
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City | SAYRE
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State | PA
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Zip | 18840-1625
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Country | US
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Telephone | 570-888-5858
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 113108-1
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License Number State | NY
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