ILDE MANUEL LEE

STATEN ISLAND, NY
NPI1639484116
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207R00000X Internal Medicine
(Licence: NY  265685)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2010-08-09
Last Update Date2012-07-05
Business Address
-- ILDE MANUEL LEE
110 BARD AVE APT 4
STATEN ISLAND, NY 10310-3205
Phone number: 903-440-0013
Mailing Address
-- ILDE MANUEL LEE
110 BARD AVE APT 4
STATEN ISLAND, NY 10310-3205
Phone number: 903-440-0013