Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208D00000X | General Practice Physician | MA030851 | NJ |
NPI | 1043344377 |
---|---|
Provider Name | Dr. Hoe-Yong Lee |
First Address | Short Hills, NJ 07078-3002 |
Second Address | Union, NJ 07083-3526 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C10210 | (02) | NJ |
P-0009 | CERTIFIED ACUPUNCTURIST (01) | NJ |