Individual
JEE S LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
975 W WALNUT ST # IB130, INDIANAPOLIS, IN 46202-5181
(317) 278-4940
Mailing address
3418 BROADWAY, 2ND FLOOR, NEW YORK, NY 10031-7419
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
244918
NY
207R00000X
Internal Medicine Physician
Primary
002412
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02867370
—
NY
Enumeration date
03/13/2007
Last updated
09/12/2022
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