MEDICARE: ELIZABETH 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	390200000X	Student in an Organized Health Care Education/Training Program
2	207Q00000X	Family Medicine Physician	306563	NY

General Provider Information

NPI Number	:	1851746572
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH LEE MD

Provider Business Mailing Address
First Line	:	2702 BROADWAY
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10025-8701
Country	:	US
Telephone Number	:	212-304-7070
Fax Number	:

Provider Business Practice Location Address
First Line	:	2702 BROADWAY
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10025-8701
Country	:	US
Telephone Number	:	212-304-7070
Fax Number	:

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

Provider Enumeration Date	:	05/02/2016
Last Update Date	:	02/13/2023

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Directions to “ ELIZABETH LEE MD” Practice Location

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