Provider Demographics
NPI:1073904322
Name:LEE, FRANKLIN (CSSD, RD)
Entity Type:Individual
Prefix:
First Name:FRANKLIN
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:CSSD, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 ELIZABETH ST
Mailing Address - Street 2:APT #4
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-5205
Mailing Address - Country:US
Mailing Address - Phone:917-371-1234
Mailing Address - Fax:
Practice Address - Street 1:91 ELIZABETH ST
Practice Address - Street 2:APT #4
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-5205
Practice Address - Country:US
Practice Address - Phone:917-371-1234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-09
Last Update Date:2015-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY993519133V00000X, 133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic