Provider Demographics
NPI:1013944073
Name:LEE, SONYA (MD)
Entity Type:Individual
Prefix:DR
First Name:SONYA
Middle Name:
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 1:51 N 39TH ST
Mailing Address - Street 2:MOB 340
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-2640
Mailing Address - Country:US
Mailing Address - Phone:215-662-9775
Mailing Address - Fax:215-243-4668
Practice Address - Street 1:51 N 39TH ST
Practice Address - Street 2:MOB 340
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19104-2640
Practice Address - Country:US
Practice Address - Phone:215-662-9775
Practice Address - Fax:215-243-4668
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD066476L207V00000X, 207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA018173Medicaid
PA018173Medicaid
PA076974Medicare ID - Type Unspecified