Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 135989 | NY |
NPI | 1104950047 |
---|---|
Provider Name | Dr. Mary Ann Kay Wing Lee |
First Address | Brooklyn, NY 11220-2167 |
Second Address | Brooklyn, NY 11220-2167 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2007 |
Last Update Date | 25/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01164218 | (05) | NY |