Provider Demographics
NPI:1558678540
Name:LEE, ANDREA CHELSEA (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:CHELSEA
Last Name:LEE
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:20 YORK ST
Mailing Address - Street 2:SP-6-130
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510-3220
Mailing Address - Country:US
Mailing Address - Phone:203-688-2338
Mailing Address - Fax:203-688-5744
Practice Address - Street 1:20 YORK ST
Practice Address - Street 2:SP-6-130
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-3220
Practice Address - Country:US
Practice Address - Phone:203-688-2338
Practice Address - Fax:203-688-5744
Is Sole Proprietor?:No
Enumeration Date:2010-09-12
Last Update Date:2015-05-04
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Provider Licenses
StateLicense IDTaxonomies
CT002453363A00000X
CT2453363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant