Provider Demographics
NPI:1669400180
Name:LEE, CAROL M (MD)
Entity type:Individual
Prefix:DR
First Name:CAROL
Middle Name:M
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:161 MADISON AVE
Mailing Address - Street 2:SUITE 5NE
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-5421
Mailing Address - Country:US
Mailing Address - Phone:212-684-2424
Mailing Address - Fax:212-576-2579
Practice Address - Street 1:161 MADISON AVE
Practice Address - Street 2:SUITE 5NE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-5421
Practice Address - Country:US
Practice Address - Phone:212-684-2424
Practice Address - Fax:212-576-2579
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY165997207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E38712Medicare UPIN
94F89Medicare ID - Type Unspecified