Individual
PENG LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
190 MAIN ST APT C, PLYMOUTH, NH 03264-1566
(971) 325-0792
Mailing address
190 MAIN ST APT C, PLYMOUTH, NH 03264-1566
(971) 325-0792
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
052519CH00009070
OVERSEA MEDICAL INSURANCE
—
Enumeration date
09/15/2019
Last updated
09/15/2019
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