MEDICARE: DR. COURTNEY L LEE MD

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	2088F0040X	Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician	263228	NY
2	208800000X	Urology Physician	263228	NY

General Provider Information

NPI Number	:	1316187719
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. COURTNEY L LEE MD

Provider Business Mailing Address
First Line	:	60 PLAZA ST E
Second Line	:	SUITE 1L
City	:	BROOKLYN
State	:	NY
Zip	:	11238-5025
Country	:	US
Telephone Number	:	718-638-9222
Fax Number	:	718-857-1714

Provider Business Practice Location Address
First Line	:	60 PLAZA ST E
Second Line	:	SUITE 1L
City	:	BROOKLYN
State	:	NY
Zip	:	11238-5025
Country	:	US
Telephone Number	:	718-638-9222
Fax Number	:	718-857-1714

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/24/2009
Last Update Date	:	09/03/2012

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