Provider Demographics
NPI:1811056278
Name:LEE, ALICE SUI YUK (LIC AC)
Entity type:Individual
Prefix:
First Name:ALICE SUI YUK
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 IVY ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-2526
Mailing Address - Country:US
Mailing Address - Phone:401-529-9765
Mailing Address - Fax:
Practice Address - Street 1:1 BLACKSTONE PL
Practice Address - Street 2:WOMEN & INFANTS HOSPITAL
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4942
Practice Address - Country:US
Practice Address - Phone:401-529-9765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA222805171100000X
RIDA00294171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist