Victoria Lee

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Old Forge, PA

NPI 1821542440 · NPPES record last updated Aug 11, 2016

Key facts

NPI
1821542440
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
License
30862537 (PA)
Practice address
255 E Morton St
Old Forge, PA 18518-1960
Phone
(570) 457-3009
NPI assigned
Aug 11, 2016
Sex
Female
Sole proprietor
No

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
30862537PAMDStudent in an Organized Health Care Education/Training Program

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 30862537 PA Yes

Addresses

Primary practice location

255 E Morton St
Old Forge, PA 18518-1960

Mailing address

255 East Morton St
Old Forge, PA 18518
Phone (570) 457-3009

Other providers in Old Forge, PA

All providers in Old Forge, PA · Student in an Organized Health Care Education/Training Program in Pennsylvania

Sources for this page

Verify at the official NPI Registry.