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General NPI Number Information
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NPI Number | 1538576236
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Entity Type | Organization
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Legal Business Name | JOANNE LEE PHYSICAL THERAPY, P.C.
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Dates
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Enumeration Date | 07/15/2014
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Last Update Date | 09/26/2014
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Provider Practice Location Address
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Address Line | 4711 BELL BLVD
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City | BAYSIDE
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State | NY
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Zip | 11361-3333
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Country | US
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Telephone | 917-565-7040
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Fax |
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Provider Business Mailing Address
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Address Line | 4344 192ND ST FL 2
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City | FLUSHING
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State | NY
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Zip | 11358-3451
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Country | US
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Telephone | 917-565-7040
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Fax |
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Authorized Official
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Title or Position | COMPANY OWNER
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Name | JEE EUN LEE
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Credential | DPT
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Telephone | 917-565-7040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 031058
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License Number State | NY
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