Racheal Lee

Individual provider Active NPI Registered Nurse · Lisle, NY

NPI 1114428166 · NPPES record last updated Feb 26, 2018

Key facts

NPI
1114428166
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
565213-1 (NY)
Practice address
107 Edwards Hill Rd
Lisle, NY 13797-1735
Phone
(607) 760-6801
NPI assigned
Feb 26, 2018
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
565213-1NYMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 565213-1 NY Yes

Addresses

Primary practice location

107 Edwards Hill Rd
Lisle, NY 13797-1735

Mailing address

107 Edwards Hill Rd
Lisle, NY 13797-1735
Phone (607) 760-6801

Other providers in Lisle, NY

All providers in Lisle, NY · Registered Nurse in New York

Sources for this page

Verify at the official NPI Registry.