Provider Demographics
NPI:1790777894
Name:YEE, LILY (MD)
Entity Type:Individual
Prefix:
First Name:LILY
Middle Name:
Last Name:YEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:139-87 , 35TH AVE
Mailing Address - Street 2:SUITE L1
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-3551
Mailing Address - Country:US
Mailing Address - Phone:718-358-7788
Mailing Address - Fax:347-779-0236
Practice Address - Street 1:139-87 , 35TH AVE
Practice Address - Street 2:SUITE L1
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-3551
Practice Address - Country:US
Practice Address - Phone:718-358-7788
Practice Address - Fax:347-779-0236
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-16
Last Update Date:2015-10-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY193265207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01443796Medicaid
NY02H211Medicare PIN
NY01443796Medicaid