Provider Demographics
NPI:1497830293
Name:LEE, ROBERT CHU DU (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:CHU DU
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:PO BOX 1715
Mailing Address - Street 2:
Mailing Address - City:SOUTH HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07606-0315
Mailing Address - Country:US
Mailing Address - Phone:201-880-0700
Mailing Address - Fax:201-880-0701
Practice Address - Street 1:192 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-2204
Practice Address - Country:US
Practice Address - Phone:201-996-0232
Practice Address - Fax:201-996-0095
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2008-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY180837207RP1001X
NJ25MA06687400207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01732214Medicaid
G42775Medicare UPIN
44H041Medicare ID - Type Unspecified