Provider Demographics
NPI:1538519939
Name:LEE, HANNA (DO)
Entity type:Individual
Prefix:
First Name:HANNA
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 CONSTITUTION BLVD S
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-4351
Mailing Address - Country:US
Mailing Address - Phone:203-924-7334
Mailing Address - Fax:
Practice Address - Street 1:25 CONSTITUTION BLVD S
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-4351
Practice Address - Country:US
Practice Address - Phone:203-924-7334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-16
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOT017312207Q00000X
CT72525208000000X
CT718582080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases