Individual
JOHN HYUNG-IL LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
43 YAWPO AVE, STE 2, OAKLAND, NJ 07436-2717
(201) 337-0066
(201) 337-7417
Mailing address
43 YAWPO AVE, STE 2, OAKLAND, NJ 07436-2717
(504) 842-4000
(601) 261-3530
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
MD2007018548
MO
207RC0000X
Cardiovascular Disease Physician
21970
MS
207RI0011X
Interventional Cardiology Physician
Primary
MD.202601
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05322806
—
MS
05
—
1943312
—
LA
01
—
302I113087
MEDICARE PTAN
MS
01
—
3461517
UNITED HEALTHCARE
MS
01
—
6057840
HEALTHSPRING
MS
01
—
9034318
AETNA
MS
01
—
9388251
CIGNA
MS
01
—
P01109784
RAILROAD MEDICARE
MS
Enumeration date
11/19/2007
Last updated
12/03/2019
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