SUKWOO LEE GNP-C ANP-C NPI 1780985697

NPI Information

NPI: 1780985697
Provider Name: SUKWOO LEE, GNP-C, ANP-C
Classification: Nurse Practitioner - 363LA2200X
Entity Type: Individual

Specialization: Adult Health

Organization: EVANS MEDICAL FOUNDATION INC

PECOS Registration: Yes

Address:
801 MASSACHUSETTS AVENUE
BOSTON, MA
ZIP 02118
Phone: (617) 414-4376
Get Directions

Sukwoo Lee, GNP-C, ANP-C is an adult health nurse practitioner in Boston, MA with 14 years of experience. Sukwoo Lee, GNP-C, ANP-C NPI is 1780985697. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

801 MASSACHUSETTS AVENUE
BOSTON, MA
ZIP 02118-605
Phone: (617) 414-4376
Fax: (617) 414-4676

The NPI 1780985697 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/9/2010 and was last updated on 3/17/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LG0600X	Nurse Practitioner	Gerontology	RN266179	MASSACHUSETTS	No
2	363LA2200X	Nurse Practitioner	Adult Health	RN266179	MASSACHUSETTS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	110088031A	MEDICAID	MASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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