Individual
MRS. MAYRA IVELISSE LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
385 TREMONT AVE, 111 I D, EAST ORANGE, NJ 07018-1023
(973) 676-1000
(973) 395-7084
Mailing address
385 TREMONT AVE, 111 I D, EAST ORANGE, NJ 07018-1023
(973) 676-1000
(973) 395-7084
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
017150
PR
Other
Enumeration date
11/26/2007
Last updated
11/26/2007
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