Individual
KEVIN LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTITIONER
Contact information
Practice address
116 ARDMORE AVE, STATEN ISLAND, NY 10314-4428
(347) 925-1194
Mailing address
116 ARDMORE AVE, STATEN ISLAND, NY 10314-4428
(347) 925-1194
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
F432187
NY
Other
Enumeration date
01/17/2022
Last updated
01/28/2022
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