MEDICARE: DR. JANE AHN 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
1	207W00000X	Ophthalmology Physician	211733	NY

General Provider Information

NPI Number	:	1528172392
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JANE AHN LEE M.D.

Provider Business Mailing Address
First Line	:	485 PARK AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10022-1228
Country	:	US
Telephone Number	:	212-753-6464
Fax Number	:

Provider Business Practice Location Address
First Line	:	485 PARK AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10022-1228
Country	:	US
Telephone Number	:	212-753-6464
Fax Number	:

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

Provider Enumeration Date	:	08/18/2006
Last Update Date	:	01/13/2022

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