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Individual

JOHN LEE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(646) 673-2865
Mailing address
361 97TH ST, BROOKLYN, NY 11209-7802
(646) 673-2865

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
05/23/2019
Last updated
07/01/2024
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