Provider Demographics
NPI:1447597349
Name:LEE ANN MARIE CUNY
Entity Type:Organization
Organization Name:LEE ANN MARIE CUNY
Other - Org Name:LEE ANN M CUNY DO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LEE ANN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CUNY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:707-474-2263
Mailing Address - Street 1:1502 TENNESSEE ST
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94590-4627
Mailing Address - Country:US
Mailing Address - Phone:707-474-2263
Mailing Address - Fax:707-471-6519
Practice Address - Street 1:1502 TENNESSEE ST
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94590-4627
Practice Address - Country:US
Practice Address - Phone:707-474-2263
Practice Address - Fax:707-471-6519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-11
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Single Specialty