Provider Demographics
NPI:1386636546
Name:LIM, LEE GUIOK (MD)
Entity Type:Individual
Prefix:DR
First Name:LEE GUIOK
Middle Name:
Last Name:LIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:17 BARLOW DR N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-6719
Mailing Address - Country:US
Mailing Address - Phone:718-763-2564
Mailing Address - Fax:
Practice Address - Street 1:80 WESTMINSTER RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-2851
Practice Address - Country:US
Practice Address - Phone:718-462-9494
Practice Address - Fax:718-469-8459
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-15
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY119214207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC07809Medicare UPIN
NY286091Medicare ID - Type Unspecified