MEDICARE: DR. ERICA H LEE MD

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
1	207ND0101X	MOHS-Micrographic Surgery Physician	237540	NY
2	207N00000X	Dermatology Physician	237540	NY

General Provider Information

NPI Number	:	1750552899
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERICA H LEE MD

Provider Business Mailing Address
First Line	:	530 E 74TH STREET
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10022-6402
Country	:	US
Telephone Number	:	646-608-6313
Fax Number	:

Provider Business Practice Location Address
First Line	:	540 EAST 74TH STREET
Second Line	:	DERMATOLOGY DIVISION
City	:	NEW YORK
State	:	NY
Zip	:	10022-6402
Country	:	US
Telephone Number	:	646-618-2313
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/17/2008
Last Update Date	:	07/27/2021

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