Provider Demographics
NPI:1790004349
Name:LEE, BYUNG MOON (LAC)
Entity Type:Individual
Prefix:DR
First Name:BYUNG MOON
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:99 KINDERKAMACK RD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:WESTWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-3012
Mailing Address - Country:US
Mailing Address - Phone:201-497-8880
Mailing Address - Fax:
Practice Address - Street 1:99 KINDERKAMACK RD STE 302
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07675-3020
Practice Address - Country:US
Practice Address - Phone:201-497-8880
Practice Address - Fax:201-497-8881
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-21
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004222171100000X
CAAC13304171100000X
NJ25MZ00070100171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist