Provider Demographics
NPI:1740665173
Name:LEE, RACHEL (MD, MPH)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:499 FARMINGTON AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-1933
Mailing Address - Country:US
Mailing Address - Phone:860-678-0202
Mailing Address - Fax:
Practice Address - Street 1:499 FARMINGTON AVE STE 100
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-1933
Practice Address - Country:US
Practice Address - Phone:860-678-0202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-28
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME144945207W00000X
NY291880207W00000X
390200000X
CT76803207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program