Provider Demographics
NPI:1548595390
Name:LEE, JAMES C (L AC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:C
Last Name:LEE
Suffix:
Gender:M
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 BONNIEVIEW LN
Mailing Address - Street 2:
Mailing Address - City:TOWACO
Mailing Address - State:NJ
Mailing Address - Zip Code:07082-1266
Mailing Address - Country:US
Mailing Address - Phone:973-270-8843
Mailing Address - Fax:
Practice Address - Street 1:493 7TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-5534
Practice Address - Country:US
Practice Address - Phone:973-270-8843
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-13
Last Update Date:2009-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002975-1171100000X
NJ25MZ00043000171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist