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General NPI Number Information
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NPI Number | 1932273596
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Entity Type | Individual
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Provider Name | SUSAN LEE MD
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Gender | Female
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Dates
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Enumeration Date | 11/17/2006
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Last Update Date | 01/10/2019
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Provider Practice Location Address
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Address Line | 122 E 42ND ST FL 17
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City | NEW YORK
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State | NY
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Zip | 10168-1799
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Country | US
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Telephone | 929-428-2547
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Fax | 651-666-1930
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Provider Business Mailing Address
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Address Line | PO BOX 1519
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City | NEW YORK
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State | NY
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Zip | 10276-1519
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Country | US
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Telephone | 929-428-2547
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Fax | 651-666-1930
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 232555
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License Number State | NY
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