Individual
MRS. THERESA CAROL LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
420 GRAND AVE STE 101, ENGLEWOOD, NJ 07631-4141
(201) 569-7044
Mailing address
333 WILLOW ST APT 404, TEANECK, NJ 07666-4068
(847) 877-6172
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26NJ00967900
NJ
Other
Enumeration date
10/02/2019
Last updated
10/02/2019
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