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DR. KATHERINE E BLACK-LEE DPM

>> Podiatrist >> Podiatric Medicine & Surgery Service Providers

Registrant NPI Number: 1154415438

Individual Registrant:
DR. KATHERINE E BLACK-LEE DPM
Gender: F
Sole Proprietor

Location and contact information for practice:
145 DURHAM RD  MADISON, CT 06443-2674 US
Tel: 203-245-4216  Fax: --

Contact information for business:
145 DURHAM RD  MADISON, CT 06443-2674 US
Tel: 203-245-4216  Fax: --

Registration Information:
NPI: 1154415438
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y213E00000XPodiatric Medicine & Surgery Service Providers
Podiatrist
CTP000360

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
LICENSE (DPM)P000360CT01




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