Provider Demographics
NPI:1578770111
Name:LEE, HYUN Y (AC)
Entity Type:Individual
Prefix:DR
First Name:HYUN
Middle Name:Y
Last Name:LEE
Suffix:
Gender:F
Credentials:AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6549 BRADDOCK RD
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22312-2207
Mailing Address - Country:US
Mailing Address - Phone:703-750-2293
Mailing Address - Fax:818-366-7078
Practice Address - Street 1:6549 BRADDOCK RD
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22312-2207
Practice Address - Country:US
Practice Address - Phone:703-750-2293
Practice Address - Fax:818-366-7078
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0121000392171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist