Individual
JESSICA LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
200 MOTOR PKWY STE A2, HAUPPAUGE, NY 11788-5112
(631) 234-5666
(631) 234-0539
Mailing address
200 MOTOR PKWY STE A2, HAUPPAUGE, NY 11788-5112
(631) 234-5666
(631) 234-0539
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
274142
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04003590
—
NY
Enumeration date
05/12/2011
Last updated
10/08/2021
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