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NPI Code Detail

MEDICARE: SEUNG WOON LEE DPT & LAC

MEDICARE: SEUNG WOON LEE DPT & LAC
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
1171100000XAcupuncturist006540NY
2225100000XPhysical Therapist030089NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1030089OTHERNYLICENSE

General Provider Information

NPI Number : 1295027456
Entity Type Code : Individual
Provider Name (Legal Business Name) : SEUNG WOON LEE DPT & LAC
Provider Business Mailing Address
First Line : 14370 SANFORD AVE APT 1
Second Line :
City : FLUSHING
State : NY
Zip : 11355-2028
Country : US
Telephone Number : 718-747-4785
Fax Number : 917-970-8211
Provider Business Practice Location Address
First Line : 14370 SANFORD AVE APT 1
Second Line :
City : FLUSHING
State : NY
Zip : 11355-2028
Country : US
Telephone Number : 718-747-4785
Fax Number : 917-970-8211
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/06/2011
Last Update Date : 04/07/2026

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Directions to “ SEUNG WOON LEE DPT & LAC” Practice Location

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