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MR. BRUCE LEE PA
NPI 1689757288
Physician Assistant in Newark, NY

Active since October 24, 2006
1208 DRIVING PARK AVE, NEWARK, NY 14513(315) 359-2640(315) 359-2645 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mr. Bruce Lee Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. BRUCE LEE PA (NPI 1689757288) is an individual physician assistant in Newark, New York, licensed in New York (004516) and active in the NPI registry since October 2006.

NPPES Registry Identity

NPI1689757288
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameMR. BRUCE LEECredential: PA
Location Address1208 DRIVING PARK AVENewark, NY 14513-1057
Mailing Address1208 Driving Park AveNewark, NY 14513-1057 · (315) 359-2640 · Fax (315) 359-2645
Phone(315) 359-2640
Fax(315) 359-2645
Sole ProprietorNo
Enumeration DateOctober 24, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1689757288 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in NY · 004516
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
1208 DRIVING PARK AVE, Newark, NY 14513
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Other Identifiers 2

Medicare ID-Type UnspecifiedG70365NY
Medicare UPINR70818NY

Other Providers at the Same Location NPPES 18

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KULJINDER DEOL M.D
Internal Medicine
1208 DRIVING PARK AVE
NEWARK, NY 14513
Wayne County (315) 359-2640
KAREN S. ROTH ANP-BC, ACHPN
Nurse Practitioner (Adult Health)
1208 DRIVING PARK AVE
NEWARK, NY 14513
Wayne County (315) 359-2640
DR. ANTHONY J DASILVA M.D.
Internal Medicine
1208 DRIVING PARK AVE
NEWARK, NY 14513
Wayne County (315) 359-2640
BEVERLY J PROVO GNPC
Nurse Practitioner (Family)
1208 DRIVING PARK AVE
NEWARK, NY 14513
Wayne County (315) 359-2640
MS. KATHLEEN M COLLINS GNP
Nurse Practitioner (Gerontology)
1208 DRIVING PARK AVE
NEWARK, NY 14513
Wayne County (315) 359-2640
CARL ROBERT LESTER NP
Nurse Practitioner (Adult Health)
1208 DRIVING PARK AVE
NEWARK, NY 14513
Wayne County (315) 359-2640
MISS ADRIENNE ALVARO NP
Nurse Practitioner (Primary Care)
1208 DRIVING PARK AVE
NEWARK, NY 14513
Wayne County (315) 359-2640
MRS. CAROL LEE NP
Nurse Practitioner
1208 DRIVING PARK AVE
NEWARK, NY 14513
Wayne County (315) 359-2640

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bruce Lee's NPI number?

The NPI number for Bruce Lee is 1689757288. It was assigned to this individual provider in the NPPES registry on October 24, 2006.

Where is Bruce Lee located?

Bruce Lee practices at 1208 Driving Park Ave, Newark, NY 14513. The listed phone number is (315) 359-2640.

What is Bruce Lee's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Bruce Lee was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.