Provider Demographics
NPI:1972557270
Name:LEE, ANTHONY (MD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1 LEIGHTON ST
Mailing Address - Street 2:UNIT 323
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02141-1875
Mailing Address - Country:US
Mailing Address - Phone:617-945-1185
Mailing Address - Fax:617-945-1185
Practice Address - Street 1:1 LEIGHTON ST
Practice Address - Street 2:UNIT 323
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02141-1875
Practice Address - Country:US
Practice Address - Phone:617-945-1185
Practice Address - Fax:617-945-1185
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-20
Last Update Date:2010-04-20
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Provider Licenses
StateLicense IDTaxonomies
CAG78279207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG22221Medicare UPIN