Provider Demographics
NPI:1083311559
Name:HYUN JI LEE MD PC
Entity Type:Organization
Organization Name:HYUN JI LEE MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CMO
Authorized Official - Prefix:
Authorized Official - First Name:HYUN JI
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-216-9580
Mailing Address - Street 1:352 7TH AVE RM 601
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-5189
Mailing Address - Country:US
Mailing Address - Phone:212-216-9580
Mailing Address - Fax:646-850-4904
Practice Address - Street 1:352 7TH AVE RM 601
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-5189
Practice Address - Country:US
Practice Address - Phone:212-216-9580
Practice Address - Fax:646-850-4904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-14
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty