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General NPI Number Information
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NPI Number | 1760633788
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Entity Type | Organization
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Legal Business Name | LEEVISION OPHTHALMOLOGY SERVICES PLLC
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Dates
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Enumeration Date | 10/08/2008
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Last Update Date | 10/09/2008
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Provider Practice Location Address
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Address Line | 142-18 38TH AVE. SUITE #1A
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City | FLUSHING
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State | NY
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Zip | 11354
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Country | US
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Telephone | 718-461-5050
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Fax | 718-461-5656
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Provider Business Mailing Address
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Address Line | 142-18 38TH AVE. SUITE #1A
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City | FLUSHING
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State | NY
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Zip | 11354
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Country | US
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Telephone | 718-461-5050
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Fax | 718-461-5656
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID H. LEE
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Credential |
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Telephone | 718-461-5050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 205979
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License Number State | NY
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