Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0102X | Surgical Critical Care | 291861 | NY |
NPI | 1104261551 |
---|---|
Provider Name | Andrew Yi-Shie Lee |
First Address | Staten Island, NY 10314-5555 |
Second Address | Brooklyn, NY 11209-7104 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2013 |
Last Update Date | 17/11/2020 |