Individual
DR. MODESTUS LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5 PERRYRIDGE ROAD, GREENWICH HOSPITAL NICU, GREENWICH, CT 06830-4697
(203) 863-3542
(203) 863-3816
Mailing address
PO BOX 673, OLD GREENWICH, CT 06870-0673
(203) 863-3542
(203) 863-3816
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
038874
CT
2080N0001X
Neonatal-Perinatal Medicine Physician
038874
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50GREENEOCT01
ANTHEM
CT
01
—
P1126523
OXFORD
—
Enumeration date
07/27/2006
Last updated
09/11/2025
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