Individual
CLARA LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
18 PERSHING AVE, LOCUST VALLEY, NY 11560-2330
(516) 662-0445
Mailing address
18 PERSHING AVE, LOCUST VALLEY, NY 11560-2330
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
278097
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/01/2012
Last updated
01/30/2015
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