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General NPI Number Information
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NPI Number | 1699193482
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Entity Type | Individual
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Provider Name | JENNIFER JOOYOUNG LEE MD
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Gender | Female
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Dates
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Enumeration Date | 03/31/2014
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Last Update Date | 12/23/2019
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Provider Practice Location Address
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Address Line | 622 W 168TH ST PH5-133
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City | NEW YORK
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State | NY
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Zip | 10032-3720
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Country | US
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Telephone | 212-305-3226
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Fax | 212-305-3204
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Provider Business Mailing Address
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Address Line | 10 FOREST AVE
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City | OLD TAPPAN
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State | NJ
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Zip | 07675-7118
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Country | US
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Telephone | 201-618-0880
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 300389
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License Number State | NY
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