Individual provider · Type 1 NPI

Ian Teddy Lee

Student in an Organized Health Care Education/Training Program · Philadelphia, PA

NPI number 1134042690 Active

Practice location

240 South 40th Street, Office Of Clinical AFFAIRS-S6A Evans
Philadelphia, PA 19104

Call (215) 573-2588 Map

Mailing address

240 S 40th St, Office Of Clinical AFFAIRS-S6A Evans
Philadelphia, PA 19104-6030

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1134042690

Ian Teddy Lee's National Provider Identifier is 1134042690, issued on Aug 3, 2026. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Philadelphia, PA. The record was last updated on Aug 3, 2026.