Provider Demographics
NPI:1063581742
Name:LEE, LESLEY H (MD)
Entity type:Individual
Prefix:DR
First Name:LESLEY
Middle Name:H
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 N 7TH STREET
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17046-5040
Mailing Address - Country:US
Mailing Address - Phone:717-273-1710
Mailing Address - Fax:717-273-1416
Practice Address - Street 1:128 N GEORGE ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17401-1117
Practice Address - Country:US
Practice Address - Phone:717-848-6116
Practice Address - Fax:717-848-6215
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010559932084P0800X
PAMD056801L2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010039550Medicaid
PA1024620520002Medicaid
VA189534OtherANTHEM
VA299066OtherAMERIGROUP
VA546001103002OtherTRICARE
VA0072OtherCAREFIRST BCBS
VA189534OtherANTHEM
VA004945026Medicare ID - Type UnspecifiedPROVIDER NUMBER