Doctor Name: | JOSIE LEE |
NPI Number: | 1700232816 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 18KT00638400 |
Business Practice Address: | 346 South Ave Suite 4 Fanwood, NJ - 070231373 |
Business Phone Number: | 9082887682 |
Business Fax Number: | |
Mailing Address: | 346 South Ave, Suite 4 FANWOOD |
State: | NJ |
Postal Code: | 070231373 |
Phone Number: | 9082887682 |
Fax Number: | |
NPI Enumeration Date: | 05/06/2016 |
NPI Last Update Date: | 05/06/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WM1400X |
License Number: | 18KT00638400 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Nurse Massage Therapist (NMT) |
Taxonomy Definition: |