Individual
DR. RUSSELL D LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
15 S MAIN ST, SUITE 170, JAMESTOWN, NY 14701-6626
(716) 483-1183
(716) 664-4903
Mailing address
15 S MAIN ST, SUITE 300, JAMESTOWN, NY 14701-6626
(716) 483-1183
(716) 664-4903
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
258146
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03338612
—
NY
01
—
J400168929
MEDICARE PTAN
NY
Enumeration date
01/26/2006
Last updated
02/18/2016
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