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General NPI Number Information
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NPI Number | 1679032809
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Entity Type | Individual
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Provider Name | ANASTASIA YUN LEE NP-C
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Gender | Female
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Dates
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Enumeration Date | 03/18/2019
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Last Update Date | 08/02/2019
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Provider Practice Location Address
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Address Line | 2901 JOLLY RD
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City | PLYMOUTH MEETING
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State | PA
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Zip | 19462-2324
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Country | US
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Telephone | 484-636-9398
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Fax |
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Provider Business Mailing Address
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Address Line | 2920 HANNAH AVE APT D238
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City | NORRISTOWN
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State | PA
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Zip | 19401-1591
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Country | US
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Telephone | 484-636-9398
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | SP01706
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | SP019706
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License Number State | PA
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