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General NPI Number Information
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NPI Number | 1154502045
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Entity Type | Individual
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Provider Name | JOHN HYUNG-IL LEE M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/19/2007
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Last Update Date | 12/03/2019
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Provider Practice Location Address
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Address Line | 43 YAWPO AVE STE 2
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City | OAKLAND
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State | NJ
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Zip | 07436-2717
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Country | US
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Telephone | 201-337-0066
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Fax | 201-337-7417
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Provider Business Mailing Address
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Address Line | 43 YAWPO AVE STE 2
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City | OAKLAND
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State | NJ
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Zip | 07436-2717
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Country | US
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Telephone | 504-842-4000
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Fax | 601-261-3530
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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 | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | MD.202601
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 21970
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | MD2007018548
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License Number State | MO
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