Individual
JEAN LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-4600
(215) 707-4034
Mailing address
2450 W HUNTING PARK AVE, 3/208N, PHILADELPHIA, PA 19129-1302
(215) 707-4739
(215) 707-3677
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
MD028188E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011575400007
—
PA
Enumeration date
10/12/2005
Last updated
06/28/2011
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