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General NPI Number Information
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NPI Number | 1518840842
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Entity Type | Individual
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Provider Name | MARY ELIZABETH LEE APN, CPNP-AC
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Gender | Female
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Dates
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Enumeration Date | 07/25/2025
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 19 DAVIS AVE FL 5
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City | NEPTUNE
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State | NJ
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Zip | 07753-4488
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Country | US
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Telephone | 732-897-3400
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Fax | 732-897-3481
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Provider Business Mailing Address
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Address Line | 135 PIERCE DR
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City | OCEAN
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State | NJ
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Zip | 07712-2844
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Country | US
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Telephone | 201-696-2679
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 26NR16804500
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 26NJ15283300
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License Number State | NJ
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