Individual
MADONNA EDINA LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
20 YORK ST, NEW HAVEN, CT 06510-3220
(203) 688-4242
Mailing address
1050 STATE ST APT 443, NEW HAVEN, CT 06511-2776
(517) 282-5983
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
69180
CT
208600000X
Surgery Physician
MD60947052
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/13/2011
Last updated
07/20/2021
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