Provider Demographics
NPI:1326241910
Name:LEE, EUGENE SEUNGKYU (DC)
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:SEUNGKYU
Last Name:LEE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 RIVER RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:EDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:07020-1171
Mailing Address - Country:US
Mailing Address - Phone:201-943-7768
Mailing Address - Fax:201-943-7798
Practice Address - Street 1:725 RIVER RD
Practice Address - Street 2:SUITE 102
Practice Address - City:EDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:07020-1171
Practice Address - Country:US
Practice Address - Phone:201-943-7768
Practice Address - Fax:212-943-7798
Is Sole Proprietor?:No
Enumeration Date:2007-06-09
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00636500111N00000X
NY010764111N00000X
NJ25MZ00048000171100000X
NY002925171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No111N00000XChiropractic ProvidersChiropractor