Provider Demographics
NPI:1275518490
Name:LEE, SYLVIA S (M D)
Entity Type:Individual
Prefix:DR
First Name:SYLVIA
Middle Name:S
Last Name:LEE
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2130 MILLBURN AVE
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040
Mailing Address - Country:US
Mailing Address - Phone:973-763-5787
Mailing Address - Fax:973-763-8568
Practice Address - Street 1:2130 MILLBURN AVE
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040
Practice Address - Country:US
Practice Address - Phone:973-763-5787
Practice Address - Fax:973-763-8568
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2009-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA053317207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ60006533OtherHORIZON NJ HEALTH
NJ0071749Medicaid
NJ8828709Medicaid
NJP3239785OtherOXFORD
NM2099741OtherGHI
NJ3258228OtherAETNA
NJ0150142000OtherAMERIHEALTH
NJ2622101OtherCIGNA
NJ236425OtherAMERIGROUP
NJ2432568OtherUNITED HEALTHCARE
NJ91001701700OtherAMERICHOICE
NJ38766OtherUNIVESITY HEALTH PLAN
NJ0071749Medicaid
NJ3258228OtherAETNA