Provider Demographics
NPI:1881690022
Name:LEE, PAUL S (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:S
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 E 60TH ST STE 2002
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-1017
Mailing Address - Country:US
Mailing Address - Phone:212-889-3550
Mailing Address - Fax:212-696-1190
Practice Address - Street 1:30 E 60TH ST STE 2002
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1017
Practice Address - Country:US
Practice Address - Phone:212-889-3550
Practice Address - Fax:212-696-1190
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-22
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY219832-1207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02530096Medicaid
NYH98970Medicare UPIN
NY02530096Medicaid