Organization
SIRENA MEDICAL AESTHETICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN LEE MD (OWNER)
(860) 269-4808
Entity
Organization
Contact information
Practice address
914 HARTFORD TPKE, WATERFORD, CT 06385-4263
(860) 269-4808
(718) 672-3280
Mailing address
12 HALLS RD UNIT 909, OLD LYME, CT 06371-7041
(718) 672-2824
(718) 672-3280
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
000723
CT
363AS0400X
Surgical Physician Assistant
000723
CT
Other
Enumeration date
02/06/2018
Last updated
02/06/2018
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