Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 231035 | NY |
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 231035 | NY |
NPI | 1154355253 |
---|---|
Provider Name | Wah Sang Lee |
First Address | Brooklyn, NY 11214-4110 |
Second Address | New York, NY 10013-4803 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 20/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02729124 | (05) | NY |
I41453 | (02) | NY |