Healthcare Provider Details

I. General information

NPI: 1720991698
Provider Name (Legal Business Name): HAJAR LEE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 COLUMBUS DR STE 300
JERSEY CITY NJ
07302-3551
US

IV. Provider business mailing address

132 NEWARK AVE
JERSEY CITY NJ
07302-2812
US

V. Phone/Fax

Practice location:
  • Phone: 201-366-1115
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number18KT01195900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: