Healthcare Provider Details

I. General information

NPI: 1336209485
Provider Name (Legal Business Name): ALEXANDER LEE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 03/04/2024
Certification Date: 03/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27005 76TH AVE STE O4000
NEW HYDE PARK NY
11040-1496
US

IV. Provider business mailing address

27005 76TH AVE STE O4000
NEW HYDE PARK NY
11040-1496
US

V. Phone/Fax

Practice location:
  • Phone: 718-470-7330
  • Fax: 718-343-9762
Mailing address:
  • Phone: 718-470-7330
  • Fax: 718-343-9762

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number220637
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number220637
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: