Provider Demographics
NPI:1679808265
Name:LEE, ANNA HYUN (DC)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:HYUN
Last Name:LEE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 MAIN ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-5017
Mailing Address - Country:US
Mailing Address - Phone:201-530-0060
Mailing Address - Fax:201-530-0061
Practice Address - Street 1:920 MAIN ST
Practice Address - Street 2:SUITE 5
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-5017
Practice Address - Country:US
Practice Address - Phone:201-530-0060
Practice Address - Fax:201-530-0061
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-15
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00601100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor