Physician Compare National (NPI:1033467915)

HEALTHCARE PROVIDER: ALLEN MA LEE O.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1033467915
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8628367489
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20160517002608
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	LEE
	Individual professional last name
Provider First Name	ALLEN MA
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	NEW ENGLAND COLLEGE OF OPTOMETRY
	Individual professional's medical school
Graduation Year	2012
	Individual professional's medical school graduation year
Primary Specialty	OPTOMETRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	2520 WHITE BEAR AVE N
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE B
	Group Practice or individual's line 2 address
City	MAPLEWOOD
	Group Practice or individual's city
State	MN
	Group Practice or individual's state
Zip Code	551095136
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	M