Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 285849 | NY |
Y | 111NI0900X | Internist | 285849 | NY |
NPI | 1003159054 |
---|---|
Provider Name | Dr. Sunyoung Lee |
First Address | Kew Gardens, NY 11415-1905 |
Second Address | Elmhurst, NY 11373-1329 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2013 |
Last Update Date | 22/02/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
04660037 | (05) | NY |