Provider Demographics
NPI:1982985610
Name:LEE, SOPHIA YUNGWEN (MD)
Entity Type:Individual
Prefix:DR
First Name:SOPHIA
Middle Name:YUNGWEN
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 1:13617 39TH AVE
Mailing Address - Street 2:4TH FLOOR SUITE CF-E
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-5504
Mailing Address - Country:US
Mailing Address - Phone:718-559-3600
Mailing Address - Fax:718-559-3636
Practice Address - Street 1:13617 39TH AVE
Practice Address - Street 2:4TH FLOOR SUITE CF-E
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5504
Practice Address - Country:US
Practice Address - Phone:718-559-3600
Practice Address - Fax:718-559-3636
Is Sole Proprietor?:No
Enumeration Date:2011-09-08
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY264443207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine