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General NPI Number Information
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NPI Number | 1497044986
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Entity Type | Individual
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Provider Name | CHARLES LEE D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 04/05/2011
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 350 BLOOMFIELD AVE STE 5
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City | BLOOMFIELD
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State | NJ
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Zip | 07003-4852
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Country | US
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Telephone | 201-463-0240
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Fax | 718-466-8126
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Provider Business Mailing Address
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Address Line | 355 TOM HUNTER RD
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City | FORT LEE
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State | NJ
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Zip | 07024-4608
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Country | US
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Telephone | 204-463-0240
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | N006605
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License Number State | NY
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