Individual
MS. KELLY M LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
658 MALTA AVE., STE 101, MALTA, NY 12020
(518) 580-0553
(518) 580-0557
Mailing address
658 MALTA AVE, STE 101, MALTA, NY 12020
(518) 580-0553
(518) 580-0557
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
295570
NY
207W00000X
Ophthalmology Physician
Primary
295570-01
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03425445
—
NJ
Enumeration date
04/03/2017
Last updated
09/05/2023
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