Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 195169 | NY |
N | 208600000X | Surgeon | 195169 | NY |
Y | 2086S0129X | Vascular Surgeon | 195169 | NY |
NPI | 1134176126 |
---|---|
Provider Name | Andy M Lee |
First Address | Flushing, NY 11355-5045 |
Second Address | Flushing, NY 11355-5045 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2006 |
Last Update Date | 05/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
020053884 | RAILROAD MEDICARE-CRT (01) | NY |
02171566 | (05) | NY |
G93203 | (02) | NY |