Provider Demographics
NPI:1497029680
Name:LEE, PAUL K (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:K
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:32 WALNUT LN
Mailing Address - Street 2:
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-5715
Mailing Address - Country:US
Mailing Address - Phone:617-817-8275
Mailing Address - Fax:516-562-4793
Practice Address - Street 1:32 WALNUT LN
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-5715
Practice Address - Country:US
Practice Address - Phone:617-817-8275
Practice Address - Fax:516-562-4793
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-06
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY602517322085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology