MEDICARE: KAITLIN R LEE M.D.

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
1	207V00000X	Obstetrics & Gynecology Physician	MD18432	RI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710203666
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAITLIN R LEE M.D.

Provider Business Mailing Address
First Line	:	70 KENYON AVE
Second Line	:
City	:	WAKEFIELD
State	:	RI
Zip	:	02879-4239
Country	:	US
Telephone Number	:	401-789-0661
Fax Number	:	401-788-3958

Provider Business Practice Location Address
First Line	:	70 KENYON AVE
Second Line	:
City	:	WAKEFIELD
State	:	RI
Zip	:	02879-4239
Country	:	US
Telephone Number	:	401-789-0661
Fax Number	:	401-788-3958

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2010
Last Update Date	:	02/10/2026

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