Provider Demographics
NPI:1508263138
Name:LEE, ROBERT (ND, MS, MA)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:ND, MS, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 VILLAGE ST STE 3
Mailing Address - Street 2:
Mailing Address - City:NORTH HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06473-3827
Mailing Address - Country:US
Mailing Address - Phone:203-239-3400
Mailing Address - Fax:
Practice Address - Street 1:12 VILLAGE ST STE 3
Practice Address - Street 2:
Practice Address - City:NORTH HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06473-3827
Practice Address - Country:US
Practice Address - Phone:203-239-3400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-25
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT528175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath