Individual
MR. JOHN LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1276 FULTON AVE, PSYCHIATRY - MMTP, BRONX, NY 10456-3402
(718) 503-7794
(718) 503-7751
Mailing address
5836 FIELDSTON RD, PRIVATE HOUSE, BRONX, NY 10471-2212
(718) 601-3192
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
363AMO700X
NY
Other
Enumeration date
11/01/2006
Last updated
07/08/2007
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