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General NPI Number Information
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NPI Number | 1902182397
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Entity Type | Organization
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Legal Business Name | SCARSDALE INTEGRATIVE FAMILY MEDICINE PLLC
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Dates
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Enumeration Date | 10/29/2011
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Last Update Date | 12/16/2011
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Provider Practice Location Address
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Address Line | 2 OVERHILL RD STE 260
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City | SCARSDALE
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State | NY
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Zip | 10583-5334
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Country | US
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Telephone | 914-722-9440
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Fax | 914-722-9441
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Provider Business Mailing Address
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Address Line | 2 OVERHILL RD STE 260
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City | SCARSDALE
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State | NY
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Zip | 10583-5334
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Country | US
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Telephone | 914-722-9440
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Fax | 914-722-9441
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. HYUN JOON LEE
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Credential | M.D
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Telephone | 914-722-9440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 229053
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License Number State | NY
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