Healthcare Provider Details

I. General information

NPI: 1356428817
Provider Name (Legal Business Name): PETER YEE LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

253 SOUTH ST
NEW YORK NY
10002-7827
US

IV. Provider business mailing address

253 SOUTH ST
NEW YORK NY
10002-7827
US

V. Phone/Fax

Practice location:
  • Phone: 212-720-4564
  • Fax: 212-732-9297
Mailing address:
  • Phone: 212-720-4564
  • Fax: 212-732-9297

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number043955-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: