Individual
MS. GERTRUDE L LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
23 PEACH TER, NEWBURGH, NY 12550-1265
(845) 561-6005
Mailing address
23 PEACH TER, NEWBURGH, NY 12550-1265
(845) 561-6005
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
220785
NY
163WC0400X
Case Management Registered Nurse
220785
NY
163WC1500X
Community Health Registered Nurse
Primary
220785
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AWAITING NPI #
—
NY
05
—
NEEDS NPI# TO ISSUE
—
NY
Enumeration date
06/06/2008
Last updated
06/06/2008
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