Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | MA072929 | NJ |
NPI | 1073527560 |
---|---|
Provider Name | James W Lee |
First Address | Hackensack, NJ 07601-7083 |
Second Address | Moorestown, NJ 08057-3146 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2006 |
Last Update Date | 19/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
367381 | AETNA (01) | |
9038302 | (05) | NJ |
F64623 | (02) | |
P00221926 | RAILROAD MEDICARE (01) |