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General NPI Number Information
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NPI Number | 1225821010
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Entity Type | Individual
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Provider Name | MS. SUKJOO LEE
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Gender | Female
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Dates
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Enumeration Date | 05/26/2025
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Last Update Date | 03/25/2026
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Provider Practice Location Address
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Address Line | 1250 GRAND CONCOURSE
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City | BRONX
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State | NY
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Zip | 10456-2759
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Country | US
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Telephone | 917-435-1666
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Fax |
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Provider Business Mailing Address
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Address Line | 2649 STRANG BLVD STE 304
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City | YORKTOWN HEIGHTS
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State | NY
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Zip | 10598-2938
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Country | US
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Telephone |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F355762
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 26NJ15333800
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 578196
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License Number State | NY
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