Provider Demographics
NPI:1336274489
Name:LEE, JU-CHENG (MD)
Entity Type:Individual
Prefix:DR
First Name:JU-CHENG
Middle Name:
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 1:58 AVON DR
Mailing Address - Street 2:
Mailing Address - City:ESSEX FELLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07021-1712
Mailing Address - Country:US
Mailing Address - Phone:973-228-0866
Mailing Address - Fax:973-228-0522
Practice Address - Street 1:58 AVON DR
Practice Address - Street 2:
Practice Address - City:ESSEX FELLS
Practice Address - State:NJ
Practice Address - Zip Code:07021-1712
Practice Address - Country:US
Practice Address - Phone:973-228-0866
Practice Address - Fax:973-228-0522
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02223300207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology