Provider Demographics
NPI:1912569930
Name:LEE, JOCELYN PACLEB
Entity Type:Individual
Prefix:MRS
First Name:JOCELYN
Middle Name:PACLEB
Last Name:LEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-4729
Mailing Address - Country:US
Mailing Address - Phone:516-643-2494
Mailing Address - Fax:516-539-1548
Practice Address - Street 1:10663 E KIVA AVE
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85209-1569
Practice Address - Country:US
Practice Address - Phone:480-357-8426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-29
Last Update Date:2019-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor