Provider Demographics
NPI:1790031896
Name:LEE, HENRY YOU-MIN
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:YOU-MIN
Last Name:LEE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:97 CHESTER ST
Mailing Address - Street 2:APT A1
Mailing Address - City:ALLSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02134-2253
Mailing Address - Country:US
Mailing Address - Phone:617-893-2085
Mailing Address - Fax:
Practice Address - Street 1:97 CHESTER ST
Practice Address - Street 2:APT A1
Practice Address - City:ALLSTON
Practice Address - State:MA
Practice Address - Zip Code:02134-2253
Practice Address - Country:US
Practice Address - Phone:617-893-2085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-26
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA253693171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist