=====================================================
General NPI Number Information
=====================================================
NPI Number | 1114904844
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | YOGSING C LEE MD PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/23/2005
-----------------------------------------------------
Last Update Date | 09/23/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 37 BUENA VISTA RD
-----------------------------------------------------
City | NEW CITY
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10956-1303
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 845-634-4772
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 37 BUENA VISTA RD
-----------------------------------------------------
City | NEW CITY
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10956-1303
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 845-634-4772
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. YOGSING C LEE
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 845-634-4772
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RC0000X
-----------------------------------------------------
Taxonomy Name | Cardiovascular Disease Physician
-----------------------------------------------------
License Number | 121614
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------