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General NPI Number Information
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NPI Number | 1447811336
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Entity Type | Organization
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Legal Business Name | LEE PODIATRY PLLC
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Dates
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Enumeration Date | 06/22/2019
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Last Update Date | 06/22/2019
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Provider Practice Location Address
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Address Line | 12 N 7TH AVE
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City | MOUNT VERNON
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State | NY
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Zip | 10550-2026
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Country | US
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Telephone | 914-361-6918
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Fax | 914-664-2873
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Provider Business Mailing Address
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Address Line | 5 ANDERSON ST APT 201
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City | NEW ROCHELLE
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State | NY
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Zip | 10801-6454
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Country | US
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Telephone | 917-832-0408
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Fax |
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Authorized Official
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Title or Position | PODIATRIST
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Name | DR. DAE YONG LEE
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Credential | DPM
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Telephone | 917-832-0408
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP1100X
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Taxonomy Name | Podiatric Clinic/Center
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License Number |
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License Number State |
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