Individual
JEAN TUAN LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
63 MAIN ST, BROCKTON, MA 02301-4042
(508) 559-6699
(508) 583-4649
Mailing address
63 MAIN ST, BROCKTON, MA 02301-4042
(508) 559-6699
(508) 559-5073
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
159687
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0017612
NEIGHBORHOOD HEALTH PLAN
—
01
—
32531
HEALTHY START
MA
01
—
32531
CHILDRENS MEDICAL SECURIT
—
01
—
J25607
BLUE CROSS BLUE SHIELD
—
Enumeration date
07/26/2006
Last updated
06/11/2010
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