MEDICARE: FUNG CHU LEE MSW-BILINGUAL

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	1041C0700X	Clinical Social Worker		NY
2	1041C0700X	Clinical Social Worker	069740	NY

General Provider Information

NPI Number	:	1952889222
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FUNG CHU LEE MSW-BILINGUAL

Provider Business Mailing Address
First Line	:	2285 E 29TH ST FL 2
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-5056
Country	:	US
Telephone Number	:	718-938-1525
Fax Number	:

Provider Business Practice Location Address
First Line	:	2285 E 29TH ST FL 2
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-5056
Country	:	US
Telephone Number	:	718-938-1525
Fax Number	:

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

Provider Enumeration Date	:	07/30/2018
Last Update Date	:	07/30/2018

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