Provider Demographics
NPI:1841291473
Name:LEE, ELAINE CHOY (MD)
Entity type:Individual
Prefix:
First Name:ELAINE
Middle Name:CHOY
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:395 BROADWAY
Mailing Address - Street 2:#10D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-3539
Mailing Address - Country:US
Mailing Address - Phone:212-966-1478
Mailing Address - Fax:212-625-1769
Practice Address - Street 1:395 BROADWAY
Practice Address - Street 2:#10D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-3539
Practice Address - Country:US
Practice Address - Phone:212-966-1478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNYS 139887208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA64263Medicare UPIN