Provider Demographics
NPI:1225140403
Name:LEE, SUN HEE LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:SUN
Middle Name:HEE LEE
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:SUN
Other - Middle Name:HEE LEE
Other - Last Name:PARK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1608 LEMOINE AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-5622
Mailing Address - Country:US
Mailing Address - Phone:201-944-2858
Mailing Address - Fax:201-944-2872
Practice Address - Street 1:1608 LEMOINE AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-5622
Practice Address - Country:US
Practice Address - Phone:201-944-2858
Practice Address - Fax:201-944-2872
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA029736208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics