Provider Demographics
NPI:1477902252
Name:LEE, CHRISTINA SUN (DO)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:SUN
Last Name:LEE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 WALKER ST FL 2
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4135
Mailing Address - Country:US
Mailing Address - Phone:212-226-8866
Mailing Address - Fax:212-226-2289
Practice Address - Street 1:13626 37TH AVE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-6533
Practice Address - Country:US
Practice Address - Phone:718-886-1222
Practice Address - Fax:718-886-7576
Is Sole Proprietor?:No
Enumeration Date:2016-06-13
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOT017204208000000X
NY298070208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY298070OtherNEW YORK STATE LICENSE