Healthcare Provider Details

I. General information

NPI: 1821603838
Provider Name (Legal Business Name): LEE VISION ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2020
Last Update Date: 10/11/2020
Certification Date: 10/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 LAKE DR E STE 105
CHERRY HILL NJ
08002-1165
US

IV. Provider business mailing address

PO BOX 825493
PHILADELPHIA PA
19182-5493
US

V. Phone/Fax

Practice location:
  • Phone: 856-809-4200
  • Fax: 856-306-5231
Mailing address:
  • Phone: 856-809-4200
  • Fax: 856-306-5231

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: STEPHEN Y LEE
Title or Position: OWNER
Credential: MD
Phone: 610-812-4539