Provider Demographics
NPI:1750657607
Name:LEE, ELLEN HYUN-JU (MD)
Entity type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:HYUN-JU
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:42-09 28TH STREET, 6TH FLOOR
Mailing Address - Street 2:2 GOTHAM CENTER, CN 22A
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101
Mailing Address - Country:US
Mailing Address - Phone:917-647-4199
Mailing Address - Fax:347-396-2753
Practice Address - Street 1:42-09 28TH STREET, 6TH FLOOR
Practice Address - Street 2:2 GOTHAM CENTER, CN 22A
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101
Practice Address - Country:US
Practice Address - Phone:917-647-4199
Practice Address - Fax:347-396-2753
Is Sole Proprietor?:No
Enumeration Date:2012-03-26
Last Update Date:2012-03-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY227235208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics