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NPI Code Detail

MEDICARE: MS. ALEXIS W LEE MA

MEDICARE: MS. ALEXIS W LEE MA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1437707676
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ALEXIS W LEE MA
Provider Business Mailing Address
First Line : 12479 CEDAR RD APT 203
Second Line :
City : CLEVELAND HEIGHTS
State : OH
Zip : 44106-5209
Country : US
Telephone Number : 860-966-6509
Fax Number :
Provider Business Practice Location Address
First Line : 22001 FAIRMOUNT BLVD
Second Line :
City : CLEVELAND
State : OH
Zip : 44118-4897
Country : US
Telephone Number : 216-932-2800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2019
Last Update Date : 08/30/2019

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