Provider Demographics
NPI:1740594290
Name:LUCY S. LEE, O.D., P.L.L.C.
Entity Type:Organization
Organization Name:LUCY S. LEE, O.D., P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:MISS
Authorized Official - First Name:SHERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHULTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-333-1250
Mailing Address - Street 1:19369 PROMENADE DR
Mailing Address - Street 2:SUITE K102
Mailing Address - City:LANSDOWNE
Mailing Address - State:VA
Mailing Address - Zip Code:20176-6501
Mailing Address - Country:US
Mailing Address - Phone:571-333-1250
Mailing Address - Fax:571-333-1251
Practice Address - Street 1:19369 PROMENADE DR
Practice Address - Street 2:SUITE K102
Practice Address - City:LANSDOWNE
Practice Address - State:VA
Practice Address - Zip Code:20176-6501
Practice Address - Country:US
Practice Address - Phone:571-333-1250
Practice Address - Fax:571-333-1251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-27
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618001284152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty