Sukwoo Lee, GNP-C, ANP-C
Nurse Practitioner, Adult Health in Boston, MA. Individual provider (NPI-1).
NPI number1780985697
StatusActive
Last updated in NPPESMar 17, 2022
Details
- NPI
- 1780985697
- Entity type
- Individual (NPI-1)
- Name
- Sukwoo Lee
- Credential
- GNP-C, ANP-C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Nov 9, 2010
- Certification date
- Mar 4, 2022
- Last updated
- Mar 17, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LA2200X | Nurse Practitioner, Adult Health | RN266179 | MA | Yes |
| 363LG0600X | Nurse Practitioner, Gerontology | RN266179 | MA |
Practice location
801 Massachusetts AvenueCrosstown 2
Boston, MA 02118-2605
Phone 617-414-7399 · Fax 617-414-4676
Mailing address
801 Albany StreetFl G
Boston, MA 02119-2371
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