Basic Information
| Provider Information | |||||||||
| NPI: | 1356564231 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LEE | ||||||||
| FirstName: | JOYCE | ||||||||
| MiddleName: | E | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | NP | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | PANAYIL | ||||||||
| OtherFirstName: | JOYCE | ||||||||
| OtherMiddleName: | |||||||||
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| OtherCredential: | NP | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 230 WORCESTER ST | ||||||||
| Address2: | HARVARD VANGAURD MEDICAL ASSOCIATES | ||||||||
| City: | WELLESLEY | ||||||||
| State: | MA | ||||||||
| PostalCode: | 024815420 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7814315429 | ||||||||
| FaxNumber: | 7814315548 | ||||||||
| Practice Location | |||||||||
| Address1: | 230 WORCESTER ST | ||||||||
| Address2: | HARVARD VANGUARD MEDICAL ASSOCIATES OB/GYN | ||||||||
| City: | WELLESLEY | ||||||||
| State: | MA | ||||||||
| PostalCode: | 024815420 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7814315429 | ||||||||
| FaxNumber: | 7814315429 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/10/2007 | ||||||||
| LastUpdateDate: | 03/09/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 268952 | MA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.