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General NPI Number Information
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NPI Number | 1366225146
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Entity Type | Individual
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Provider Name | DIANA LEE
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Gender | Female
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Dates
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Enumeration Date | 08/16/2023
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Last Update Date | 08/16/2023
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Provider Practice Location Address
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Address Line | 1283 YORK AVENUE 15TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10065
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Country | US
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Telephone | 212-746-5454
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Fax |
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Provider Business Mailing Address
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Address Line | 800 PARK AVE APT 1604
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City | FORT LEE
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State | NJ
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Zip | 07024-3774
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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 |
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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 | 163WN0002X
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Taxonomy Name | Neonatal Intensive Care Registered Nurse
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License Number | 739868
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License Number State | NY
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