Healthcare Provider Details

I. General information

NPI: 1053927764
Provider Name (Legal Business Name): JUHEE LEE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2020
Last Update Date: 09/17/2020
Certification Date: 09/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 1ST AVE
NEW YORK NY
10029-7494
US

IV. Provider business mailing address

333 E 93RD ST APT 4C
NEW YORK NY
10128-5510
US

V. Phone/Fax

Practice location:
  • Phone: 212-424-6271
  • Fax:
Mailing address:
  • Phone: 929-360-9635
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: