Provider Demographics
NPI:1245274976
Name:LEE-JAYARAM, JANNET JIEYUN (MD)
Entity type:Individual
Prefix:DR
First Name:JANNET
Middle Name:JIEYUN
Last Name:LEE-JAYARAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JANNET
Other - Middle Name:JIEYUN
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3224 FIELDCREST CT
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-2875
Mailing Address - Country:US
Mailing Address - Phone:917-853-4433
Mailing Address - Fax:
Practice Address - Street 1:ERIE AVENUE AT FRONT STREET
Practice Address - Street 2:ST. CHRISTOPHER'S HOSPITAL FOR CHILDREN EMERGENCY DEPT
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19134
Practice Address - Country:US
Practice Address - Phone:215-427-8431
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT1869302080P0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine