Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 208820 | NY |
NPI | 1013901693 |
---|---|
Provider Name | Christopher Sang Don Lee |
First Address | Vineland, NJ 08360-6933 |
Second Address | Vineland, NJ 08360-6933 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/09/2005 |
Last Update Date | 04/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I11989 | (02) | NY |