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DR. KATHERINE E BLACK-LEE DPM
>> Podiatrist >> Podiatric Medicine & Surgery Service ProvidersRegistrant NPI Number: 1154415438
Individual Registrant:DR. KATHERINE E BLACK-LEE DPM
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
145 DURHAM RD MADISON, CT 06443-2674 US
Tel: 203-245-4216 Fax: --
Tel: 203-245-4216 Fax: --
Contact information for business:
145 DURHAM RD MADISON, CT 06443-2674 US
Tel: 203-245-4216 Fax: --
Tel: 203-245-4216 Fax: --
Registration Information:
NPI: 1154415438
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 213E00000X | Podiatric Medicine & Surgery Service Providers Podiatrist | CT | P000360 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| LICENSE (DPM) | P000360 | CT | 01 |
