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General NPI Number Information
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NPI Number | 1023889862
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Entity Type | Individual
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Provider Name | KYLE CHO LEE
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Gender | Male
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Dates
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Enumeration Date | 01/10/2024
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Last Update Date | 01/10/2024
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Provider Practice Location Address
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Address Line | 26 COURT ST
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City | BROOKLYN
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State | NY
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Zip | 11242-0103
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Country | US
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Telephone | 929-298-4684
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Fax |
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Provider Business Mailing Address
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Address Line | 6037 E LANE AVE
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City | FRESNO
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State | CA
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Zip | 93727-5636
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Country | US
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Telephone | 559-974-8262
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 111278
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | P125473
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License Number State | NY
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