Individual
DR. DONALD R LEE-EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D,MD,LP
Contact information
Practice address
255 GORDON ST, STATEN ISLAND, NY 10304-1943
(718) 554-0744
(206) 337-9412
Mailing address
255 GORDON ST, STATEN ISLAND, NY 10304-1943
(718) 554-0744
(206) 337-9412
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
4053692
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1710252127
NPI
NY
Enumeration date
05/14/2012
Last updated
05/14/2012
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