Healthcare Provider Details

I. General information

NPI: 1326950593
Provider Name (Legal Business Name): MING-HSUAN LEE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 JERICHO TPKE STE 120
SYOSSET NY
11791-4501
US

IV. Provider business mailing address

158 ADIRONDACK DR
SELDEN NY
11784-3752
US

V. Phone/Fax

Practice location:
  • Phone: 212-226-5530
  • Fax:
Mailing address:
  • Phone: 516-492-8167
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number360993
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: