Provider Demographics
NPI:1629124045
Name:LEE, KAREN T (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:T
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8324 CORNISH AVE
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-3794
Mailing Address - Country:US
Mailing Address - Phone:718-424-0770
Mailing Address - Fax:718-424-2590
Practice Address - Street 1:8324 CORNISH AVE
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-3794
Practice Address - Country:US
Practice Address - Phone:718-424-0770
Practice Address - Fax:718-424-2590
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY242926207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1000049664OtherAFFINITY
NY6533075OtherCIGNA
NYP3871911OtherOXFORD
NY02903226Medicaid
NY242926-A39OtherHEALTHFIRST
NY398900POtherHIP
NY6C3272OtherHEALTHNET
NY002800132002OtherUHC COMMUNITY PLAN
NY193029OtherELDER PLAN
NY1011674POtherEMBLEM HEALTH
NY24292601OtherNEIGHBORHOOD
NY3680S1OtherEMPIRE BC/BS
NY071128000030OtherFIDELIS
NY100280013201OtherAMERICHOICE
NY537920101OtherHEALTHPLUS