Provider Demographics
NPI:1104026392
Name:LEE, JESSICA M (MD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:M
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:85 SEYMOUR ST
Mailing Address - Street 2:SUITE 415
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106
Mailing Address - Country:US
Mailing Address - Phone:860-246-2071
Mailing Address - Fax:860-524-2650
Practice Address - Street 1:85 SEYMOUR ST
Practice Address - Street 2:SUITE 415
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106
Practice Address - Country:US
Practice Address - Phone:860-246-2071
Practice Address - Fax:860-524-2650
Is Sole Proprietor?:No
Enumeration Date:2007-07-25
Last Update Date:2013-07-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT052108208600000X, 2086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT16011719-1AOtherUCONN ID