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General NPI Number Information
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NPI Number | 1497776348
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Entity Type | Organization
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Legal Business Name | JUNG S LEE MD, PC
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Dates
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Enumeration Date | 07/23/2006
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Last Update Date | 07/31/2007
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Provider Practice Location Address
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Address Line | 320 ABINGTON DR SUITE #1
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City | WYOMISSING
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State | PA
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Zip | 19610-1898
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Country | US
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Telephone | 610-678-3007
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Fax | 610-678-9845
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Provider Business Mailing Address
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Address Line | 320 ABINGTON DR SUITE #1
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City | WYOMISSING
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State | PA
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Zip | 19610-1898
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Country | US
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Telephone | 610-678-3007
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Fax | 610-678-9845
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Authorized Official
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Title or Position | OWNER
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Name | JUNG SOOK LEE
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Credential | MD
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Telephone | 610-678-3007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD037840L
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License Number State | PA
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