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General NPI Number Information
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NPI Number | 1942798855
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Entity Type | Individual
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Provider Name | DIANA SUWEN LEE MD
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Gender | Female
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Dates
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Enumeration Date | 04/26/2018
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Last Update Date | 02/05/2025
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Provider Practice Location Address
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Address Line | 550 1ST AVE
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City | NEW YORK
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State | NY
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Zip | 10016-6402
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Country | US
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Telephone | 212-263-5506
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Fax |
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Provider Business Mailing Address
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Address Line | 211 TIONDA DR S APT 1
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City | VANDALIA
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State | OH
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Zip | 45377-2440
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Country | US
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Telephone | 585-747-8681
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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 | 207RA0401X
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Taxonomy Name | Addiction Medicine (Internal Medicine) Physician
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License Number | 308054
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 308054
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License Number State | NY
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