Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 25 MA09199100 | NJ |
N | 207RI0200X | Infectious Disease | 257405 | NY |
NPI | 1013245869 |
---|---|
Provider Name | Yeon Joo Lee |
First Address | New York, NY 10017-6706 |
Second Address | New York, NY 10065-6007 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2009 |
Last Update Date | 07/04/2015 |