Organization
SUFFIELD PEDIATRIC AND ADOLESCENT MEDICINE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA J LEE APRN (OWNER)
(860) 836-5416
Entity
Organization
Contact information
Practice address
230C MOUNTAIN RD, SUFFIELD, CT 06078-3019
(860) 836-5416
Mailing address
65 BROOKSIDE DR, SUFFIELD, CT 06078-1530
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/25/2023
Last updated
08/25/2023
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