Individual
JIAE LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 920-4321
Mailing address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 920-4321
Taxonomy
Speciality
Code
Description
License number
State
2084E0001X
Epilepsy Physician
305381
NY
2084N0400X
Neurology Physician
Primary
305381
NY
Other
Enumeration date
05/10/2016
Last updated
05/20/2025
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