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General NPI Number Information
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NPI Number | 1629433404
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Entity Type | Organization
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Legal Business Name | RYE BROOK CARDIOLOGY & VASCULAR MEDICINE, P.C.
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Dates
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Enumeration Date | 12/22/2015
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Last Update Date | 12/22/2015
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Provider Practice Location Address
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Address Line | 14 RYE RIDGE PLZ STE. 234
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City | RYE BROOK
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State | NY
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Zip | 10573-2826
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Country | US
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Telephone | 914-251-1070
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Fax | 914-935-9047
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Provider Business Mailing Address
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Address Line | 14 RYE RIDGE PLZ STE. 234
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City | RYE BROOK
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State | NY
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Zip | 10573-2826
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Country | US
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Telephone | 914-251-1070
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Fax | 914-935-9047
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MYUNG-HO LEE
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Credential | M.D., FACC, RVT
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Telephone | 914-251-1070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 182644-1
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License Number State | NY
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