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NPI Code Detail

MEDICARE: JESSICA HAEWON LEE MD

MEDICARE: JESSICA HAEWON 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
12084N0400XNeurology PhysicianMD493436PA

General Provider Information

NPI Number : 1881086544
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA HAEWON LEE MD
Provider Business Mailing Address
First Line : 555 N DUKE ST
Second Line :
City : LANCASTER
State : PA
Zip : 17602-2250
Country : US
Telephone Number : 717-396-9167
Fax Number : 717-396-9064
Provider Business Practice Location Address
First Line : 555 N DUKE ST
Second Line :
City : LANCASTER
State : PA
Zip : 17602-2250
Country : US
Telephone Number : 717-396-9167
Fax Number : 717-396-9064
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2015
Last Update Date : 05/04/2026

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