MEDICARE: CATHERINE NHUNG LEE DPM, P.C.

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
1	332B00000X	Durable Medical Equipment & Medical Supplies	N005793-1	NY

General Provider Information

NPI Number	:	1154702884
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CATHERINE NHUNG LEE DPM, P.C.

Provider Business Mailing Address
First Line	:	1 W 85TH ST
Second Line	:	APT 1C
City	:	NEW YORK
State	:	NY
Zip	:	10024-4134
Country	:	US
Telephone Number	:	212-874-0564
Fax Number	:	212-496-8548

Provider Business Practice Location Address
First Line	:	1545 UNIONPORT RD
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10462-7714
Country	:	US
Telephone Number	:	718-892-2200
Fax Number	:	718-828-9663

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. CATHERINE NHUNG LEE
Credential	:	DPM
Telephone Number	:	718-892-2200

Provider Enumeration Date	:	06/18/2015
Last Update Date	:	06/18/2015

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