Provider Demographics
NPI:1417931494
Name:LEE, JUNG HI (MD)
Entity Type:Individual
Prefix:
First Name:JUNG HI
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 1:10 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:PENNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08534-4221
Mailing Address - Country:US
Mailing Address - Phone:609-730-0218
Mailing Address - Fax:
Practice Address - Street 1:STUYVESANT AVE
Practice Address - Street 2:
Practice Address - City:WEST TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08628
Practice Address - Country:US
Practice Address - Phone:609-777-1996
Practice Address - Fax:609-633-1312
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ341142084F0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0541605Medicaid
AL7971383OtherDEA
LE182296Medicare ID - Type Unspecified
AL7971383OtherDEA