Provider Demographics
NPI:1629146196
Name:SHUM, KEE YEE (MD)
Entity Type:Individual
Prefix:
First Name:KEE
Middle Name:YEE
Last Name:SHUM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:136 25 MAPLE AVENUE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-3891
Mailing Address - Country:US
Mailing Address - Phone:718-463-2245
Mailing Address - Fax:718-463-2290
Practice Address - Street 1:136 25 MAPLE AVENUE
Practice Address - Street 2:SUITE 205
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3891
Practice Address - Country:US
Practice Address - Phone:718-463-2245
Practice Address - Fax:718-463-2290
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2015-03-08
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Provider Licenses
StateLicense IDTaxonomies
NY151697207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01066339Medicaid
B79942Medicare UPIN
B79942Medicare UPIN