Provider Demographics
NPI:1932362936
Name:LEE-GRASSO, BARBARA E
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:E
Last Name:LEE-GRASSO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 23831
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07189-0831
Mailing Address - Country:US
Mailing Address - Phone:973-971-7184
Mailing Address - Fax:973-290-8349
Practice Address - Street 1:180 JFK DR STE 320
Practice Address - Street 2:
Practice Address - City:ATLANTIS
Practice Address - State:FL
Practice Address - Zip Code:33462-6641
Practice Address - Country:US
Practice Address - Phone:561-548-4900
Practice Address - Fax:614-345-1655
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN08050200363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health