Healthcare Provider Details

I. General information

NPI: 1013164037
Provider Name (Legal Business Name): YUN JU LEE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2008
Last Update Date: 01/21/2025
Certification Date: 01/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 SYLVAN AVE STE 102
ENGLEWOOD CLIFFS NJ
07632-2505
US

IV. Provider business mailing address

120 SYLVAN AVE STE 102
ENGLEWOOD CLIFFS NJ
07632-2505
US

V. Phone/Fax

Practice location:
  • Phone: 201-886-0077
  • Fax:
Mailing address:
  • Phone: 201-886-0077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA01157100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: