Lee, Russell D

Lee, Russell D is an individual health care provider with primary practice located at 15 S Main St Suite 170, Jamestown NY 14701-6626. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Lee, Russell D can be contacted via phone (716) 483-1183.

Contact Information

Primary practice address
15 S Main St Suite 170 Jamestown NY 14701-6626
Phone: (716) 483-1183
Fax: (716) 664-4903
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 258146 New York

Profile Details

NPI number 1972573277
LBN Legal business name Lee, Russell D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 26th, 2006
Last updated Feb 18th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972573277 NPPES
New York MEDICAID 03338612
New York Other J400168929

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