Provider Demographics
NPI:1477614618
Name:LEE, ALEXANDER (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 MEEHAN LN
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864-1413
Mailing Address - Country:US
Mailing Address - Phone:401-658-2525
Mailing Address - Fax:401-658-3031
Practice Address - Street 1:2 MEEHAN LN
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:RI
Practice Address - Zip Code:02864-1413
Practice Address - Country:US
Practice Address - Phone:401-658-2525
Practice Address - Fax:401-658-3031
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2013-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY236208208000000X
RIMD13305208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIPY01057Medicaid