Mary Rose Quan Lee-Llacer, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

180723 Issued in NY

Practice address

766 Woolley Ave
Staten Island, NY 10314-4248

Phone

(718) 698-0980

NPI assigned

Feb 21, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750416970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "766 WOOLLEY AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103144248",
            "telephone_number": "718-698-0980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "766 WOOLLEY AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103144248",
            "telephone_number": "718-698-0980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE-LLACER",
        "first_name": "MARY ROSE",
        "middle_name": "QUAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "180723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward Leccese, LMT
• Lynda Lederer Elbaz, M.S.
• Josiane Lederman, M.D.
• Lee M Turner LCSW, PC
• Donald R Lee-Edwards, PH.D,MD,LP
• Adrienne D Lee, M.S.CCC/SLP
• Alex Lee
• Andy Sangyoon Lee
• Anita Cher-Jen Lee, PA-C
• April Lee, MD

• Internal Medicine Physician in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.