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General NPI Number Information
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NPI Number | 1578985040
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Entity Type | Individual
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Provider Name | KA YEON LEE MD
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Gender | Female
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Dates
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Enumeration Date | 01/17/2014
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Last Update Date | 12/19/2024
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Provider Practice Location Address
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Address Line | 260 OLD HOOK RD STE 300
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City | WESTWOOD
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State | NJ
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Zip | 07675-3123
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Country | US
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Telephone | 201-408-5314
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Fax |
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Provider Business Mailing Address
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Address Line | 260 OLD HOOK RD STE 300
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City | WESTWOOD
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State | NJ
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Zip | 07675-3123
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Country | US
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Telephone | 201-408-5314
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Fax | 201-781-5992
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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 | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 25MA12418900
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License Number State | NJ
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