Healthcare Provider Details

I. General information

NPI: 1114132701
Provider Name (Legal Business Name): JOSHUA DAVID LEE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 11/22/2024
Certification Date: 11/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BELLEVUE HOSPITAL 460 FIRST AVE
NEW YORK NY
10016
US

IV. Provider business mailing address

180 MADISON AVE FL 17
NEW YORK NY
10016-5267
US

V. Phone/Fax

Practice location:
  • Phone: 212-562-3000
  • Fax:
Mailing address:
  • Phone: 646-221-3171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License Number220463
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: