Provider Demographics
NPI:1316936180
Name:LEE, KAROLYN F (MD)
Entity type:Individual
Prefix:
First Name:KAROLYN
Middle Name:F
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 1:40 BUTTRICK RD
Mailing Address - Street 2:
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-3381
Mailing Address - Country:US
Mailing Address - Phone:603-552-1400
Mailing Address - Fax:603-552-1499
Practice Address - Street 1:40 BUTTRICK RD
Practice Address - Street 2:
Practice Address - City:LONDONDERRY
Practice Address - State:NH
Practice Address - Zip Code:03053-3381
Practice Address - Country:US
Practice Address - Phone:603-552-1400
Practice Address - Fax:603-552-1499
Is Sole Proprietor?:No
Enumeration Date:2005-10-14
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH12800207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH494240OtherTUFTS
NH31119YOtherANTHEM RAN REFERRAL #
NHAA39926OtherHPHC
NH30205289Medicaid
NH3304222OtherCIGNA PIN
NH1131433OtherAETNA PIN
NHAA39926OtherHPHC
NH30205289Medicaid