Provider Demographics
NPI:1942500707
Name:SOOKWOOK LEE MD PC
Entity Type:Organization
Organization Name:SOOKWOOK LEE MD PC
Other - Org Name:ARA MEDICAL CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SOOKWOOK
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PC
Authorized Official - Phone:212-574-4994
Mailing Address - Street 1:12 W 32ND ST
Mailing Address - Street 2:FL 2
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-3813
Mailing Address - Country:US
Mailing Address - Phone:212-574-4994
Mailing Address - Fax:917-517-1320
Practice Address - Street 1:12 W 32ND ST
Practice Address - Street 2:FL 2
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-3813
Practice Address - Country:US
Practice Address - Phone:212-574-4994
Practice Address - Fax:914-517-1320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-27
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY249997207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty