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NPI Code Detail

MEDICARE: CHANG HO LEE BROOKLYN MEDICAL PC

MEDICARE: CHANG HO LEE BROOKLYN MEDICAL PC
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
1208100000XPhysical Medicine & Rehabilitation Physician195375-1NY

General Provider Information

NPI Number : 1801180138
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHANG HO LEE BROOKLYN MEDICAL PC
Provider Business Mailing Address
First Line : 745 64TH ST
Second Line : 2 FL
City : BROOKLYN
State : NY
Zip : 11220-4745
Country : US
Telephone Number : 718-745-1888
Fax Number :
Provider Business Practice Location Address
First Line : 745 64TH ST
Second Line : 2 FL
City : BROOKLYN
State : NY
Zip : 11220-4745
Country : US
Telephone Number : 718-745-1888
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : CHANG HO LEE
Credential : MD
Telephone Number : 718-745-1888
Provider Enumeration Date : 06/03/2011
Last Update Date : 06/03/2011

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Directions to “CHANG HO LEE BROOKLYN MEDICAL PC ” Practice Location

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