Provider Demographics
NPI:1730390089
Name:LEE, JENNIFER ROBIN (MD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:ROBIN
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 MAIN ST
Mailing Address - Street 2:LOWER LEVEL, SUITE L-1
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-3216
Mailing Address - Country:US
Mailing Address - Phone:203-623-6941
Mailing Address - Fax:
Practice Address - Street 1:225 MAIN ST
Practice Address - Street 2:LOWER LEVEL, SUITE L-1
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-3216
Practice Address - Country:US
Practice Address - Phone:203-623-6941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2366012084P0800X
CT0437562084P0804X
PA4272452084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry