Provider Demographics
NPI:1740096718
Name:LEE, HEJI GRACE (PA-C)
Entity type:Individual
Prefix:
First Name:HEJI
Middle Name:GRACE
Last Name:LEE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4000 PRESIDENTIAL BLVD APT 710
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19131-1718
Mailing Address - Country:US
Mailing Address - Phone:609-206-6200
Mailing Address - Fax:
Practice Address - Street 1:2600 W 9TH ST
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19013-2040
Practice Address - Country:US
Practice Address - Phone:484-480-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-05
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant