Provider Demographics
NPI:1972825628
Name:LEE, VERONICA (NP, DNP(C))
Entity Type:Individual
Prefix:MS
First Name:VERONICA
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:NP, DNP(C)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3332 WALDEN AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:DEPEW
Mailing Address - State:NY
Mailing Address - Zip Code:14043-2400
Mailing Address - Country:US
Mailing Address - Phone:716-681-2231
Mailing Address - Fax:
Practice Address - Street 1:3332 WALDEN AVE STE 110
Practice Address - Street 2:
Practice Address - City:DEPEW
Practice Address - State:NY
Practice Address - Zip Code:14043-2400
Practice Address - Country:US
Practice Address - Phone:716-681-2231
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-23
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF305315-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health