Provider Demographics
NPI:1073527560
Name:LEE, JAMES W (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:W
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 MAIN ST STE 601
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-7083
Mailing Address - Country:US
Mailing Address - Phone:201-510-0910
Mailing Address - Fax:609-702-8456
Practice Address - Street 1:350 YOUNG AVE STE 200
Practice Address - Street 2:
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-3146
Practice Address - Country:US
Practice Address - Phone:609-702-1900
Practice Address - Fax:609-702-8456
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA072929207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00221926OtherRAILROAD MEDICARE
367381OtherAETNA
NJ9038302Medicaid
F64623Medicare UPIN
P00221926OtherRAILROAD MEDICARE