Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0011X | Interventional Cardiology | 25MA02776800 | NJ |
NPI | 1083788145 |
---|---|
Provider Name | William K Lee |
First Address | Oakland, NJ 07436 |
Second Address | Oakland, NJ 07436 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2006 |
Last Update Date | 09/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0788708 | (05) | NJ |
D18688 | (02) |