Individual
GINA LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC &ANP-BC
Contact information
Practice address
5836 254TH ST, LITTLE NECK, NY 11362-2124
(917) 566-7645
Mailing address
3618 171ST ST, FLUSHING, NY 11358-2209
(917) 566-7645
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
F306733-1
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F402513-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04030104
—
NY
Enumeration date
01/28/2014
Last updated
05/13/2021
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