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General NPI Number Information
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NPI Number | 1366303885
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Entity Type | Individual
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Provider Name | GABRIELLE DOMINY LEE PA-C
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Gender | Female
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Dates
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Enumeration Date | 11/24/2025
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 540 NJ-10
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City | RANDOLPH
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State | NJ
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Zip | 07869
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Country | US
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Telephone | 551-290-3085
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Fax |
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Provider Business Mailing Address
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Address Line | 540 NJ-10
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City | RANDOLPH
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State | NJ
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Zip | 07869
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Country | US
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Telephone | 609-507-2103
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State | NJ
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