Provider Demographics
NPI:1619975356
Name:LEE, JULIA LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:LYNN
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:11995 SINGLETREE LN
Mailing Address - Street 2:SUITE 500
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-5347
Mailing Address - Country:US
Mailing Address - Phone:952-595-1242
Mailing Address - Fax:952-935-2757
Practice Address - Street 1:252 7TH AVE
Practice Address - Street 2:APT. 7L
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-7326
Practice Address - Country:US
Practice Address - Phone:952-595-1242
Practice Address - Fax:952-935-2757
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2203662085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA330364OtherMEDICARE
CAP02184533OtherRAILROAD MEDICARE
CACA330363OtherMEDICARE
CAP02184512OtherRAILROAD MEDICARE
CA6273289OtherCIGNA/GREAT WEST
CACA330365OtherMEDICARE
NYP00971853OtherRXR MCR
MD446509100Medicaid
CA65726OtherPRIME HEALTH SERVICES
CACB311015OtherMEDICARE