Basic Information
| Provider Information | |||||||||
| NPI: | 1770025033 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LEE | ||||||||
| FirstName: | TOSHA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DNP, FNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1412-22 FAIRMOUNT AVENUE | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 19130 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2156845361 | ||||||||
| FaxNumber: | 2152324093 | ||||||||
| Practice Location | |||||||||
| Address1: | 1401 DEKALB ST | ||||||||
| Address2: | |||||||||
| City: | NORRISTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 194013405 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6102787787 | ||||||||
| FaxNumber: | 6102787386 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/17/2016 | ||||||||
| LastUpdateDate: | 09/22/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/02/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | SP016265 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 163WL0100X | L-49606 | PA | N | Nursing Service Providers | Registered Nurse | Lactation Consultant |
No ID Information.