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NPI Code Detail

MEDICARE: ANITA CHER-JEN LEE PA-C

MEDICARE: ANITA CHER-JEN LEE PA-C
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
1363AM0700XMedical Physician Assistant012885NY

General Provider Information

NPI Number : 1558500611
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANITA CHER-JEN LEE PA-C
Provider Business Mailing Address
First Line : 86 BOWERY
Second Line : 4TH FLOOR
City : NEW YORK
State : NY
Zip : 10013-4615
Country : US
Telephone Number : 212-219-2883
Fax Number : 212-219-2705
Provider Business Practice Location Address
First Line : 2079 FOREST AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10303-1735
Country : US
Telephone Number : 718-815-6560
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2009
Last Update Date : 02/04/2020

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