Provider Demographics
NPI:1821409335
Name:LEE, GRACE YING-SHUAN (MD)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:YING-SHUAN
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:663 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MELROSE
Mailing Address - State:MA
Mailing Address - Zip Code:02176-3139
Mailing Address - Country:US
Mailing Address - Phone:781-665-1985
Mailing Address - Fax:781-665-0226
Practice Address - Street 1:663 MAIN ST
Practice Address - Street 2:
Practice Address - City:MELROSE
Practice Address - State:MA
Practice Address - Zip Code:02176
Practice Address - Country:US
Practice Address - Phone:781-665-1985
Practice Address - Fax:781-665-0226
Is Sole Proprietor?:No
Enumeration Date:2014-05-19
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA267715207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology