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NPI Code Detail

MEDICARE: ERIC LEE PA-C

MEDICARE: ERIC LEE PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1043107113
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIC LEE PA-C
Provider Business Mailing Address
First Line : 400 GARDEN CITY PLZ STE 111
Second Line :
City : GARDEN CITY
State : NY
Zip : 11530-3336
Country : US
Telephone Number : 516-246-8800
Fax Number :
Provider Business Practice Location Address
First Line : 400 GARDEN CITY PLZ STE 111
Second Line :
City : GARDEN CITY
State : NY
Zip : 11530-3336
Country : US
Telephone Number : 516-246-8800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2025
Last Update Date : 06/21/2025

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Directions to “ ERIC LEE PA-C” Practice Location

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