Provider Demographics
NPI:1760537161
Name:KATHERINE D. LEE, MD, PC
Entity Type:Organization
Organization Name:KATHERINE D. LEE, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:QUINN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-586-8443
Mailing Address - Street 1:PO BOX 1177
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01061-1177
Mailing Address - Country:US
Mailing Address - Phone:413-584-8443
Mailing Address - Fax:413-584-8443
Practice Address - Street 1:30 LOCUST STREET
Practice Address - Street 2:ATT: OPERATING ROOM
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060
Practice Address - Country:US
Practice Address - Phone:413-584-8443
Practice Address - Fax:413-584-8443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAB33505Medicare ID - Type Unspecified
MAB72998Medicare UPIN