Provider Demographics
NPI:1356442602
Name:LEE, PATRICK (MD)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 E KINCAID DR
Mailing Address - Street 2:
Mailing Address - City:WEST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08550-2915
Mailing Address - Country:US
Mailing Address - Phone:732-887-5213
Mailing Address - Fax:
Practice Address - Street 1:100 HWY 36
Practice Address - Street 2:
Practice Address - City:WEST LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07764-1462
Practice Address - Country:US
Practice Address - Phone:732-222-1711
Practice Address - Fax:732-222-1461
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD036534207RH0003X
NJ25MA08003400207RH0003X
MDD0070344207RH0003X
VA0101250413207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJBL9749942OtherDEA NUMBER
NJBL9749942OtherDEA NUMBER