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Individual

DR. MARYANN LEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1200 SOUTH AVE, SUITE 307, STATEN ISLAND, NY 10314-3413
(718) 698-3777
(718) 698-8777
Mailing address
1200 SOUTH AVE, SUITE 307, STATEN ISLAND, NY 10314-3529
(718) 698-3777
(718) 698-8777

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25MA07938600
NJ
207RR0500X
Rheumatology Physician
Primary
239954
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00717999RAILROAD
MEDICARE RAILROAD
NY
Enumeration date
05/06/2007
Last updated
10/08/2015
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