Provider Demographics
NPI:1376845636
Name:KWOK-MAN LEE,M.D.,P.C.
Entity Type:Organization
Organization Name:KWOK-MAN LEE,M.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KWOK-MAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-732-3538
Mailing Address - Street 1:198 CANAL ST
Mailing Address - Street 2:SUITE 404
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4531
Mailing Address - Country:US
Mailing Address - Phone:212-732-3538
Mailing Address - Fax:212-732-3538
Practice Address - Street 1:198 CANAL ST
Practice Address - Street 2:SUITE 404
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4531
Practice Address - Country:US
Practice Address - Phone:212-732-3538
Practice Address - Fax:212-732-3538
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-18
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY200351207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
100131558801OtherUNITED HEALTH CARE
P393074OtherOXFORD
NY241941OtherMEDICARE
2505315OtherGHI
6806424OtherCIGNA
200351OtherHIP
200351-A31OtherHEALTH FIRST
NY01585602Medicaid
NY519602OtherAETNA
040426019577OtherFIDELIS CARE
2C5566OtherPHS
NY241941OtherMEDICARE