MEDICARE: DR. ANNA F LEE MD

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	207R00000X	Internal Medicine Physician	25MA06952000	NJ

General Provider Information

NPI Number	:	1780625038
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANNA F LEE MD

Provider Business Mailing Address
First Line	:	72 COVINGTON CIR
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10312-1175
Country	:	US
Telephone Number	:	732-991-0669
Fax Number	:

Provider Business Practice Location Address
First Line	:	465 CRANBURY RD
Second Line	:	SUIT 202
City	:	EAST BRUNSWICK
State	:	NJ
Zip	:	08816-7600
Country	:	US
Telephone Number	:	732-698-9980
Fax Number	:

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

Provider Enumeration Date	:	06/09/2006
Last Update Date	:	09/19/2011

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