Individual
GRACE SUNAH LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3401 CIVIC CENTER BLVD DIVISION OF PEDIATRIC CARDIOLOGY, PHILADELPHIA, PA 19104
(267) 590-0427
Mailing address
3401 CIVIC CENTER BLVD DIVISION OF PEDIATRIC CARDIOLOGY, PHILADELPHIA, PA 19104
(267) 590-0427
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2022-01155
NC
208000000X
Pediatrics Physician
2022-01155
NC
2080P0202X
Pediatric Cardiology Physician
Primary
MT228198
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/09/2018
Last updated
06/26/2023
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