Provider Demographics
NPI:1558432377
Name:LEE, HENRY C (MD)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:C
Last Name:LEE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:6480 MAIN STREET
Mailing Address - Street 2:SUITE #1
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-5652
Mailing Address - Country:US
Mailing Address - Phone:716-631-3300
Mailing Address - Fax:716-631-3303
Practice Address - Street 1:6480 MAIN STREET
Practice Address - Street 2:SUITE #1
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5652
Practice Address - Country:US
Practice Address - Phone:716-631-3300
Practice Address - Fax:716-631-3303
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2017-02-17
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Provider Licenses
StateLicense IDTaxonomies
NY235834 1207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02676391Medicaid
NYJ100000145Medicare PIN
NYIA1183Medicare Oscar/Certification
NYH85004Medicare UPIN
NY02676391Medicaid