Provider Demographics
NPI:1447412952
Name:LEE, HENRY (MD)
Entity Type:Individual
Prefix:
First Name:HENRY
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 1:58 MOUNT BETHEL RD
Mailing Address - Street 2:STE 302
Mailing Address - City:WARREN
Mailing Address - State:NJ
Mailing Address - Zip Code:07059-2654
Mailing Address - Country:US
Mailing Address - Phone:908-738-1160
Mailing Address - Fax:877-619-8780
Practice Address - Street 1:58 MOUNT BETHEL RD
Practice Address - Street 2:STE 302
Practice Address - City:WARREN
Practice Address - State:NJ
Practice Address - Zip Code:07059-2654
Practice Address - Country:US
Practice Address - Phone:908-738-1160
Practice Address - Fax:877-619-8780
Is Sole Proprietor?:No
Enumeration Date:2008-06-26
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT193436207W00000X
WAMD60191039207W00000X
CT051639207W00000X
NJ25MA09441300207W00000X, 207WX0200X
PAMD453009207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology