Provider Demographics
NPI:1851400451
Name:LEE, SUN H (MD)
Entity Type:Individual
Prefix:
First Name:SUN
Middle Name:H
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 PATERSON ST
Mailing Address - Street 2:2100
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-1962
Mailing Address - Country:US
Mailing Address - Phone:732-235-7756
Mailing Address - Fax:732-235-7095
Practice Address - Street 1:125 PATERSON ST
Practice Address - Street 2:2100
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-1962
Practice Address - Country:US
Practice Address - Phone:732-235-7756
Practice Address - Fax:732-235-7095
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2014-02-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA069909207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7878702Medicaid
NJ7878702Medicaid
G87905Medicare UPIN
NJ046904C5WMedicare PIN