Individual
SUKWOO LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
GNP-C, ANP-C
Contact information
Practice address
801 MASSACHUSETTS AVENUE, CROSSTOWN 2, BOSTON, MA 02118-2605
(617) 414-7399
(617) 414-4676
Mailing address
801 ALBANY STREET, FL G, BOSTON, MA 02119-2371
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN266179
MA
363LG0600X
Gerontology Nurse Practitioner
RN266179
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110088031A
—
MA
Enumeration date
11/09/2010
Last updated
03/17/2022
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