Provider Demographics
NPI:1841289998
Name:LEE, VINCENT PATRICK (RN, NP)
Entity type:Individual
Prefix:MR
First Name:VINCENT
Middle Name:PATRICK
Last Name:LEE
Suffix:
Gender:M
Credentials:RN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 BROOKHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:ROCKY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11778-9355
Mailing Address - Country:US
Mailing Address - Phone:631-744-2614
Mailing Address - Fax:631-849-3542
Practice Address - Street 1:69 BROOKHAVEN DR
Practice Address - Street 2:
Practice Address - City:ROCKY POINT
Practice Address - State:NY
Practice Address - Zip Code:11778-9355
Practice Address - Country:US
Practice Address - Phone:631-744-2614
Practice Address - Fax:631-849-3542
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF340309-1163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management