Provider Demographics
NPI:1467552257
Name:LEE, SANG OH (MD)
Entity Type:Individual
Prefix:DR
First Name:SANG
Middle Name:OH
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:37 MORNINGSIDE DR
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-1827
Mailing Address - Country:US
Mailing Address - Phone:973-535-5670
Mailing Address - Fax:973-535-5670
Practice Address - Street 1:201 LYONS AVE
Practice Address - Street 2:SUITE G4
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07112-2027
Practice Address - Country:US
Practice Address - Phone:973-926-7888
Practice Address - Fax:973-923-8232
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2016-04-26
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA04473700207UN0902X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207UN0902XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Imaging & Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8102309Medicaid
NJ8102309Medicaid
NJC72513Medicare UPIN