Doctor Name: | DR. BRYANT B LEE |
NPI Number: | 1437154960 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 25MA07925300 |
Business Practice Address: | 75e Northfield Rd Livingston, NJ - 070394532 |
Business Phone Number: | 9734361400 |
Business Fax Number: | 9086737336 |
Mailing Address: | 150 Floral Ave, NEW PROVIDENCE |
State: | NJ |
Postal Code: | 079741557 |
Phone Number: | 9082734300 |
Fax Number: | |
NPI Enumeration Date: | 06/21/2005 |
NPI Last Update Date: | 08/20/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 25MA07925300 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |