Provider Demographics
NPI:1083045488
Name:LEE, FAWCETT SIEW SUIT (APN)
Entity Type:Individual
Prefix:MISS
First Name:FAWCETT
Middle Name:SIEW SUIT
Last Name:LEE
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 BUSH PKWY
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-2207
Mailing Address - Country:US
Mailing Address - Phone:848-391-1811
Mailing Address - Fax:
Practice Address - Street 1:9 DUTCHTOWN HARLINGEN RD
Practice Address - Street 2:
Practice Address - City:BELLE MEAD
Practice Address - State:NJ
Practice Address - Zip Code:08502-5115
Practice Address - Country:US
Practice Address - Phone:908-874-8883
Practice Address - Fax:908-874-3595
Is Sole Proprietor?:No
Enumeration Date:2013-12-10
Last Update Date:2013-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00479600363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily