Provider Demographics
NPI:1013699479
Name:ALICE K. LEE, M.D.
Entity Type:Organization
Organization Name:ALICE K. LEE, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:K
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-321-2122
Mailing Address - Street 1:PO BOX 527823
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11352-7823
Mailing Address - Country:US
Mailing Address - Phone:718-321-2122
Mailing Address - Fax:718-321-0148
Practice Address - Street 1:13630 MAPLE AVE STE 1F
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3866
Practice Address - Country:US
Practice Address - Phone:718-321-2122
Practice Address - Fax:718-321-0148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-04
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty