Provider Demographics
NPI:1891766721
Name:LEE, JIN S (MD)
Entity Type:Individual
Prefix:
First Name:JIN
Middle Name:S
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:629 CRANBURY RD FL 2
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-4096
Mailing Address - Country:US
Mailing Address - Phone:732-390-7750
Mailing Address - Fax:732-390-7725
Practice Address - Street 1:1 VALLEY HEALTH PLZ
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-3628
Practice Address - Country:US
Practice Address - Phone:201-634-5353
Practice Address - Fax:201-986-4702
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2023-05-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA09588700207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA075048Medicare ID - Type Unspecified
PAH97550Medicare UPIN
PA100814949Medicaid