Provider Demographics
NPI:1245345107
Name:LEE, HARVEY Y (MD)
Entity type:Individual
Prefix:
First Name:HARVEY
Middle Name:Y
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 VALLEY FORGE DR
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19963-2108
Mailing Address - Country:US
Mailing Address - Phone:302-682-4155
Mailing Address - Fax:
Practice Address - Street 1:27 VALLEY FORGE DR
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-2108
Practice Address - Country:US
Practice Address - Phone:302-682-4155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10004843207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000714901Medicaid
DE0000714901Medicaid
DEG01784F01Medicare PIN