Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | 306905 | NY |
Y | 213ES0000X | Sports Medicine | 306905 | NY |
NPI | 1346604816 |
---|---|
Provider Name | Caroline J Lee |
First Address | New York, NY 10065-4870 |
Second Address | New York, NY 10065-4870 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2016 |
Last Update Date | 24/01/2022 |