Provider Demographics
NPI:1801180807
Name:LEE, ROBERT (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 PLAZA DR STE 17
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08757-3765
Mailing Address - Country:US
Mailing Address - Phone:732-934-4141
Mailing Address - Fax:732-442-8886
Practice Address - Street 1:3 PLAZA DR STE 17
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08757-3765
Practice Address - Country:US
Practice Address - Phone:732-934-4141
Practice Address - Fax:732-442-8886
Is Sole Proprietor?:No
Enumeration Date:2011-06-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA142026207N00000X
NJ25MA09337700207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology