Provider Demographics
NPI:1649212754
Name:LEE, HOCHANG (MD)
Entity Type:Individual
Prefix:
First Name:HOCHANG
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 1:300 CRITTENDEN BLVD BOX PSYCH
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-275-3535
Mailing Address - Fax:585-273-1093
Practice Address - Street 1:300 CRITENDEN BLVD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642-0005
Practice Address - Country:US
Practice Address - Phone:585-275-3535
Practice Address - Fax:585-273-1093
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD583012084P0800X
NY2916142084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD788104500Medicaid
MDH59206Medicare UPIN
MD788104500Medicaid