Provider Demographics
NPI:1508937269
Name:LEE, GRACE (MD)
Entity Type:Individual
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First Name:GRACE
Middle Name:
Last Name:LEE
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Gender:F
Credentials:MD
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Mailing Address - Street 1:147 MILK ST
Mailing Address - Street 2:PROVIDER ENROLLMENT 9TH FLOOR
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02109-4806
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:133 BROOKLINE AVE
Practice Address - Street 2:FERTILITY AND REPRODUCTIVE ENDOCRINOLOGY
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-3904
Practice Address - Country:US
Practice Address - Phone:617-421-1191
Practice Address - Fax:617-421-5828
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2011-06-15
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Provider Licenses
StateLicense IDTaxonomies
MA225323207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0035994OtherNEIGHBORHOOD HEALTH PLAN
MA0991522OtherCIGNA
MAJ29084OtherBLUE CROSS
MAAA39640OtherHARVARD PILGRIM
MA2106469Medicaid
MA470422OtherTUFTS HEALTH PLAN
MAAA39640OtherHARVARD PILGRIM
MA0035994OtherNEIGHBORHOOD HEALTH PLAN