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NPI Code Detail

MEDICARE: DR. DUCKJA LEE M.D.

MEDICARE: DR. DUCKJA LEE M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology Physician146835NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134121098
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DUCKJA LEE M.D.
Provider Business Mailing Address
First Line : PO BOX 32161
Second Line :
City : HARTFORD
State : CT
Zip : 06150-2161
Country : US
Telephone Number : 800-875-4886
Fax Number :
Provider Business Practice Location Address
First Line : 699 92ND ST
Second Line : VICTORY MEMORIAL HOSPITAL
City : BROOKLYN
State : NY
Zip : 11228-3619
Country : US
Telephone Number : 718-567-1234
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2005
Last Update Date : 10/31/2008

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