Healthcare Provider Details

I. General information

NPI: 1023929429
Provider Name (Legal Business Name): NOAH LEE DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HARMON PLZ
SECAUCUS NJ
07094-2803
US

IV. Provider business mailing address

105 BRAMBLE DR
MORGANVILLE NJ
07751-4072
US

V. Phone/Fax

Practice location:
  • Phone: 201-509-8205
  • Fax:
Mailing address:
  • Phone: 732-343-5622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA02443900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: