Individual
JISOO LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-4000
Mailing address
DEPT 3010, PO BOX 986524, BOSTON, MA 02298-6524
(401) 443-4992
(401) 537-7241
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD16345
RI
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
MD16345
RI
207RP1001X
Pulmonary Disease Physician
Primary
MD16345
RI
Other
Enumeration date
04/07/2014
Last updated
02/07/2024
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