Bruce Lee is a Physician Assistant in Newark, New York. Bruce Lee practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Bruce Lee is 1689757288. The last update date is 2007-07-08.
Bruce Lee's current location address is 1208 Driving Park Ave, Newark, New York. You can contact this provider via phone number 3153592640 and fax number 3153592645. The mailing address for Bruce Lee is 1208 Driving Park Ave, Newark, New York. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Bruce Lee |
|---|---|
| Address | 1208 Driving Park Ave, Newark, New York |
| Phone Number | 3153592640 |
| Fax Number | 3153592645 |
| Sole Proprietor | N |
| Credentials | PA |
NPI Number Detail
| NPI Number | 1689757288 |
|---|---|
| Provider Enumeration Date | 2006-10-24 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 1208 Driving Park Ave |
|---|---|
| City | Newark |
| State | New York (NY) |
| Post Code | 145131057 |
| Phone Number | 3153592640 |
| Fax Number | 3153592645 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 4516 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Post Comment/ Review Below
What is the Bruce Lee's 1689757288?
The Bruce Lee's NPI (National Provider Identifier) Number is 1689757288. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete street address where Bruce Lee is physically located?
The Bruce Lee is physically situated at the following address: 1208 Driving Park Ave, Newark, NY, 145131057.
What is the Bruce Lee's specialty and taxonomy code?
The Bruce Lee's specialty is Physician Assistant, and the corresponding taxonomy code is 363A00000X.
On what date did Bruce Lee receive its 1689757288 assignment from the Centers for Medicare & Medicaid Services?
The Bruce Lee was assigned its 1689757288 on 2006-10-24, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details related to Bruce Lee most recently updated or revised?
The information pertaining to Bruce Lee, including its address, specialty, and other relevant details, was last updated or revised on 2007-07-08.