Provider Demographics
NPI:1578814786
Name:LEE, WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
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 1:7 POPHAM RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-3709
Mailing Address - Country:US
Mailing Address - Phone:914-725-0800
Mailing Address - Fax:
Practice Address - Street 1:7 POPHAM RD
Practice Address - Street 2:SUITE 301
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-3709
Practice Address - Country:US
Practice Address - Phone:914-725-0800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-27
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY159862208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1020828Medicaid
NY1020828Medicaid